Why is this research needed?
Transient Ischaemic Attack (TIA) and minor stroke account for more than half of all cases of stroke.
People that have a TIA, also called ‘mini-stroke’ experience short-lasting symptoms. People that have a ‘minor stroke’ have mild and non-disabling symptoms. But there is variability in the level of recovery and severity of symptoms after TIA and minor stroke, and these patients may experience difficulties that affect their quality of life, including anxiety and depression.
After a TIA or minor stroke, people often have limited access to further specialist support from stroke-specific rehabilitation services. Current treatment for people with TIA and minor stroke mainly focuses on identifying and reducing risk factors that could cause a later stroke, such as high blood pressure.
What did the research aim to do?
This fellowship aimed to develop and evaluate a 6-week group programme, called OPTIMISM that offers educational, psychological and social support for people following TIA and minor stroke. It also aimed to understand how it could be used in the NHS and for which people with TIA and minor stroke.
How did they do this?
To develop and test the programme, Dr Kontou worked to:
- Understand our current knowledge by studying published research studies on the physical, psychological and social impact of TIA and minor stroke.
- Plan a comprehensive group programme by understanding the needs of people affected by TIA and minor stroke, and healthcare professionals.
- Test if the new group programme is acceptable and feasible to deliver by inviting people with TIA/minor stroke to take part in a small-scale clinical trial.
Dr Kontou and her colleagues found that current evidence for TIA or minor stroke programmes providing education, psychological and social support were not adequate. They found that:
- The medical diagnoses of TIA and minor stroke were not adequately defined in many studies. For example, the type and severity of problems participants were facing due to the TIA or minor stroke were not clearly reported.
- The type and content of the information and support study participants received were not adequately described. For example, in some studies it was unclear which healthcare professionals would have given these treatment programmes and how they would be trained to do so.
They developed the OPTIMISM treatment, a 6-week programme of group support that aims to meet the needs of people with TIA and minor stroke that were also identified in this research. They found that participants were able to, and wanted to take part in the new treatment programme. These innovative findings can lead to a larger trial to understand how the programme can be used in the NHS, for example which patients are offered the new treatment, and by which healthcare professionals.
This award allowed Dr Kontou to get more funding for her research, so she can continue to improve life for people affected by stroke. As well as starting new projects, she’s hoping to take research into OPTIMISM forward, so it can be widely offered to people with TIA and minor stroke in the UK.
She said “The OPTIMISM project highlighted the impact of a TIA or minor stroke diagnosis and the gaps in service provision for people diagnosed with less severe strokes. Our participants reported that no stroke is considered a minor event by those affected and our findings call for further research in this area.”
I would like to continue using my research and clinical skills to make a positive impact on the quality of care within stroke services and to continue being an Ambassador for the Stroke Association.”