Evaluation of the P ost S troke C hecklist: a pilot study in the United Kingdom and S ingapore

Background There is currently no standardized process for long‐term follow‐up care. As a result, management of poststroke care varies greatly, and the needs of stroke survivors are not fully addressed. The P ost S troke C hecklist was developed by the G lobal S troke C ommunity A dvisory P anel as a means of standardizing long‐term stroke care. Since its development, the P ost S troke C hecklist has gained international recognition from various stroke networks and is endorsed by the W orld S troke O rganization to support improved stroke survivor follow‐up and care. Aims The aim of this study was to evaluate the feasibility and usefulness of the P ost S troke C hecklist in clinical practice and assess its relevance to stroke survivors in pilot studies in the U nited K ingdom and S ingapore. Methods The P ost S troke C hecklist was administered to stroke survivors in the U nited K ingdom ( n  = 42) and S ingapore ( n  = 100) by clinicians. To assess the feasibility of the P ost S troke C hecklist in clinical practice, an independent researcher observed the assessment and made notes relating to the patient–clinician interaction and their interpretations of the P ost S troke C hecklist items. Patient and clinician satisfaction with the P ost S troke C hecklist was assessed by three questions, responded to on a 0–10 numerical rating scale. Clinicians also completed a P ragmatic F ace and C ontent V alidity test to evaluate their overall impressions of the P ost S troke C hecklist. In the U nited K ingdom, a subset of patients ( n  = 14) took part in a concept elicitation interview prior to being administered the P ost S troke C hecklist, followed by a cognitive debriefing interview to assess relevance and comprehension of the P ost S troke C hecklist. Results The P ost S troke C hecklist identified frequently reported problems for stroke survivors including cognition (reported by 47·2% of patients), mood (43·7%), and life after stroke (38%). An average of 3·2 problems per patient was identified across both countries (range 0–10). An average of 5 and 2·6 problems per patient were identified in the U nited K ingdom and S ingapore, respectively. The average time taken to administer the P ost S troke C hecklist was 17 mins (standard deviation 7·5) in S ingapore and 13 mins (standard deviation 7·6) in the U nited K ingdom. Satisfaction ratings were high for patients (8·6/10) and clinicians (7·7/10), and clinician feedback via the P ragmatic F ace and C ontent V alidity test indicated that the P ost S troke C hecklist is ‘useful’, ‘informative’, and ‘exhaustive’. All concepts measured by the P ost S troke C hecklist were spontaneously discussed by patients during the concept elicitation interviews, suggesting that the P ost S troke C hecklist is relevant to stroke survivors. Cognitive debriefing data indicated that the items were generally well understood and relevant to stroke. Minor revisions were made to the P ost S troke C hecklist based on patient feedback. Conclusions The findings suggest that the P ost S troke C hecklist is a feasible and useful measure for identifying long term stroke care needs in a clinical practice setting. Pilot testing indicated that the P ost S troke C hecklist is able to identify a wide range of unmet needs, and patient and clinician feedback indicated a high level of satisfaction with the P ost S troke C hecklist assessment. The items were generally well understood and considered relevant to stroke survivors, indicating the P ost S troke C hecklist is a feasible, useful, and relevant measure of poststroke care.