Self-Management Support Interventions for Stroke Survivors: A Systematic Meta-Review

There is considerable policy interest in promoting self-management in patients with long-term conditions, but it remains uncertain whether these interventions are effective in stroke patients. Systematic meta-review of the evidence for self-management support interventions with stroke survivors to i...

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Bibliographic Details
Published in:PloS one 2015-07, Vol.10 (7), p.e0131448-e0131448
Main Authors: Parke, Hannah L, Epiphaniou, Eleni, Pearce, Gemma, Taylor, Stephanie J C, Sheikh, Aziz, Griffiths, Chris J, Greenhalgh, Trish, Pinnock, Hilary
Format: Article
Language:English
Subjects:
Activities of Daily Living
Caregivers
Chronic illnesses
Clinical trials
Data bases
Health care
Health care industry
Humans
Literature reviews
Management
Medical research
Outcome Assessment, Health Care - methods
Patients
Problem solving
Quality assessment
Rehabilitation
Self Care - methods
Self Care - standards
Stroke
Stroke patients
Stroke Rehabilitation
Surveys and Questionnaires
Survival
Survivors
Systematic review
Therapy
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Summary:There is considerable policy interest in promoting self-management in patients with long-term conditions, but it remains uncertain whether these interventions are effective in stroke patients. Systematic meta-review of the evidence for self-management support interventions with stroke survivors to inform provision of healthcare services. We searched MEDLINE, EMBASE, CINAHL, PsychINFO, AMED, BNI, Database of Abstracts of Reviews for Effectiveness, and Cochrane Database of Systematic Reviews for systematic reviews of self-management support interventions for stroke survivors. Quality was assessed using the R-AMSTAR tool, and data extracted using a customised data extraction form. We undertook a narrative synthesis of the reviews' findings. From 12,400 titles we selected 13 systematic reviews (published 2003-2012) representing 101 individual trials. Although the term 'self-management' was rarely used, key elements of self-management support such as goal setting, action planning, and problem solving were core components of therapy rehabilitation interventions. We found high quality evidence that supported self-management in the context of therapy rehabilitation delivered soon after the stroke event resulted in short-term (< 1 year) improvements in basic and extended activities of daily living, and a reduction in poor outcomes (dependence/death). There is some evidence that rehabilitation and problem solving interventions facilitated reintegration into the community. Self-management terminology is rarely used in the context of stroke. However, therapy rehabilitation currently successfully delivers elements of self-management support to stroke survivors and their caregivers with improved outcomes. Future research should focus on managing the emotional, medical and social tasks of long-term survivorship.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0131448