Strategies to improve the quality of life of persons post-stroke: protocol of a systematic review

Sarah E P Munce, Laure Perrier, Saeha Shin, Chamila Adhihetty, Kristen Pitzul, Michelle L A Nelson, Mark T Bayley, Sarah E P Munce, Laure Perrier, Saeha Shin, Chamila Adhihetty, Kristen Pitzul, Michelle L A Nelson, Mark T Bayley

Abstract

Background: While many outcomes post-stroke (e.g., depression) have been previously investigated, there is no complete data on the impact of a variety of quality improvement strategies on the quality of life and physical and psychological well-being of individuals post-stroke. The current paper outlines a systematic review protocol on the impact of quality improvement strategies on quality of life as well as physical and psychological well-being of individuals with stroke.

Methods: MEDLINE, CINAHL, EMBASE, and PsycINFO databases will be searched. Two independent reviewers will conduct all levels of screening, data abstraction, and quality appraisal. Only randomized controlled trials that report on the impact of quality improvement strategies on quality of life outcomes in people with stroke will be included. The secondary outcomes will be physical and psychological well-being. Quality improvement strategies include audit and feedback, case management, team changes, electronic patient registries, clinician education, clinical reminders, facilitated relay of clinical information to clinicians, patient education, (promotion of) self-management, patient reminder systems, and continuous quality improvement. Studies published since 2000 will be included to increase the relevancy of findings. Results will be grouped according to the target group of the varying quality improvement strategies (i.e., health system, health care professionals, or patients) and/or by any other noteworthy grouping variables, such as etiology of stroke or by sex.

Discussion: This systematic review will identify those quality improvement strategies aimed at the health system, health care professionals, and patients that impact the quality of life of individuals with stroke. Improving awareness and utilization of such strategies may enhance uptake of stroke best practices and reduce inappropriate health care utilization costs.

Systematic review registration: PROSPERO, CRD42017064141.

Keywords: Knowledge translation; Protocol; Quality improvement; Quality of life; Stroke; Systematic review.

Conflict of interest statement

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Competing interests

The authors declare that they have no competing interests.

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References

    1. Weimar C, Kurth T, Kraywinkel K, Wagner M, Busse O, Haberl RL, German Stroke Data Bank Collaborators Assessment of functioning and disability after ischemic stroke. Stroke. 2002;33:2053–2059. doi: 10.1161/.
    1. MacKay J, Mensah G. Atlas of heart disease and stroke. Geneva: World Health. Organization; 2004.
    1. World Health Organization. Global status health report on noncommunicable diseases 2010. Geneva: World Health Organization, 2011, reprinted 2011.
    1. Lincoln NB, Gladman JR, Berman P, Noad RF, Challen K. Functional recovery of community stroke patients. Disabil Rehabil. 2000;22:135–139. doi: 10.1080/096382800296980.
    1. Patel MD, Tilling K, Lawrence E, Rudd AG, Wolfe CD, McKevitt C. Relationships between long-term stroke disability, handicap and health-related quality of life. Age Aging. 2006;35:273–279. doi: 10.1093/ageing/afj074.
    1. Clarke PJ, Black SE, Badley EM, Lawrence JM, Williams JI. Handicap in stroke survivors. Disabil Rehabil. 1999;21(3):116–123. doi: 10.1080/096382899297855.
    1. Cramer SC. Changes in motor system function and recovery after stroke. Restor Neurol Neurosci. 2004;22:231–238.
    1. D’Alisa S, Baudo S, Mauro A, Miscio G. How does stroke restrict participation in long-term post-stroke survivors? Acta Neurol Scand. 2005;112:157–162. doi: 10.1111/j.1600-0404.2005.00466.x.
    1. Morrison V, Pollard B, Johnston M, MacWalter R. Anxiety and depression 3 years following stroke: demographic, clinical, and psychological predictors. J Psychosom Res. 2005;59:209–213. doi: 10.1016/j.jpsychores.2005.02.019.
    1. Lightbody CE, Baldwin R, Connolly M, Gibbon B, Jawaid N, Leathley M, Sutton C, Watkins CL. Can nurses help identify patients with depression following stroke? A pilot study using two methods of detection. J Adv Nurs. 2007;57:505–512. doi: 10.1111/j.1365-2648.2006.04135.x.
    1. Batalden PB, Davidoff F. What is “quality improvement” and how can it transform healthcare? Qual Safe Health Care. 2007;16(1):2–3. doi: 10.1136/qshc.2006.022046.
    1. Cochrane Effective Practice and Organisation of Care. Suggested risk of bias criteria for EPOC reviews. 2017. . Accessed 20 Apr 2017.
    1. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:2535. doi: 10.1136/bmj.b2535.
    1. Shojania KG, Ranji SR, McDonald KM, Grimshaw JM, Sundaram V, Rushakoff RJ, Owens DK. Effects of quality improvement strategies for type 2 diabetes on glycemic control: a meta-regression analysis. JAMA. 2006;296:427–440. doi: 10.1001/jama.296.4.427.
    1. Tricco AC, Ivers NM, Grimshaw JM, Moher D, Turner L, Galipeau J, Halperin I, Vachon B, Ramsay T, Manns B, Tonelli M, Shojania K. Effectiveness of quality improvement strategies on the management of diabetes: a systematic review and meta-analysis. Lancet. 2012;379:2252–2261. doi: 10.1016/S0140-6736(12)60480-2.
    1. World Health Organization . Report of WHOQOL focus group work. Geneva: World Health Organization; 1993.
    1. Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1:385–10.1177/014662167700100306. doi: 10.1177/014662167700100306.
    1. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67:361–370. doi: 10.1111/j.1600-0447.1983.tb09716.x.
    1. Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21:1539–1558. doi: 10.1002/sim.1186.
    1. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7:177–188. doi: 10.1016/0197-2456(86)90046-2.
    1. World Health Organization: Composite international diagnostic interview (CIDI), version 10. World Health Organization edition. 1990, Geneva: World Health Organization.
    1. Higgins JPT, Green S (editors): Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from .

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