Eligible studies evaluated interventions involving both a health care and social care element suitable for post-discharge and annual review of a stroke-care strategy. Interventions could include review of medications and assessment of longer-term disability and caregiver needs and provision of information and signposting to other services. Studies had to be aimed at people over 18 years of age in primary care with a diagnosis of stroke. Outcomes of interest were patient satisfaction, patient health outcomes, levels of depression, patient behaviour, levels of function, quality of life, caregiver burden scales and readmission to hospital. Studies that evaluated secondary prevention alone or ongoing community-based rehabilitation were excluded.
Interventions used stroke support workers, care co-ordinators, case managers or a care management model linked to systems of recall and clinical guidelines in primary care. The duration of the interventions ranged from three to 12 months. Over half the studies were from the UK and the remainder were reported to be from North America. Few studies described the relationship between the intervention worker and the primary care services. Limited information was provided on the theoretical basis of the interventions. Most of the studies excluded patients who had lived in nursing homes. Only two studies included patients with caregivers.
One reviewer conducted the search. At least two reviewers independently screened studies for inclusion. Disagreements were resolved through consensus or by reference to a third reviewer.