Comprehensive evaluation of telehealth outpatient stroke service in rural and remote Australia: a multicentre study protocol.

Introduction: Without guideline-based secondary management, ~10%-20% of stroke patients suffer a recurrent event within 12 months. Access to stroke specialists in rural areas is scarce, which may limit appropriate secondary prevention interventions and potentially explain the worse stroke outcomes shown in rural areas. We developed a hybrid model telestroke clinic (stroke specialist remotely by video and stroke coordinator face-to-face) at four rural hospitals in Australia. The aims were to determine the effect on recurrent cerebrovascular events, patient acceptability and cost for the hybrid clinic compared with previous usual care. We hypothesise that patients assessed through the clinic would have a decreased rate of recurrent cerebrovascular events at 12 months compared with those patients managed through standard pathways. Methods and analysis: This is a retrospective, multicentre (four sites) observational service evaluation study, comparing a hybrid telestroke outpatient clinic model of care with standard care. Ethics and dissemination: Ethics approval for the hybrid telestroke clinic data was obtained from the Hunter New England Human Research Ethics Committee (2021/ETH00452). Ethics approval for the control population was obtained from the Hunter New England Human Research Ethics Committee (HNEHREC Reference No. 13/02/20/5.06) with further amendment (AU201712-15). Trial registration number: ACTRN12625000447459. Registration date 13/5/2025.