Assessment of Process Evaluations of Complex Stroke Rehabilitation and Secondary Stroke Prevention Trials—A Scoping Review

Abstract

Background

Complexity of interventions and lack of methodological clarity makes process evaluations (PEs) challenging. Assessment of PEs conducted for complex stroke rehabilitation and nonpharmacologic secondary stroke prevention interventions is lacking with only one study conducted for the latter. To address this gap, we conducted a scoping review.

Methods

Development and reporting of review follows Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Reviews. Research questions were identified and search phrases developed according to keywords on 3 electronic databases: PubMed, Web of Science, and Cochrane Library. All titles and available abstracts were independently reviewed by 2 authors and disagreements settled by other authors. Inclusion criteria centered on complex secondary stroke nonpharmacologic prevention or a rehabilitation trial.

Results

Selected studies (n = 11) were derived from (n = 24) articles reporting on PE of main trial (n = 10). Studies are from 2015 onward with 9 studies for stroke rehabilitation and 1 from secondary stroke prevention, out of these 7 are randomized clinical trials. Medical Research Council’s framework was most widely used with common data collection method being interviews, surveys and log records. More than half of the studies are mobile health based which reveals future for stroke rehabilitation and stroke prevention interventions. We identified 3 themes on qualitative analysis of articles.

Conclusion

Paucity of relevant research studies indicates that more research should be carried out for PEs in stroke rehabilitation and prevention. Researchers in future may find guidance from this review where we support clarity on framework and its elements that helped to evaluate methodology.