Charting a new course in research on stroke rehabilitation for complex patients

Dr. Michelle Nelson is the lead author on a paper published this month that defines a research agenda aiming to address the pressing need to enhance care for this increasingly complex patient population. In the paper, Michelle and her colleagues note that fewer than six per cent of strokes occur in individuals with no other health conditions. However, stroke patients with multiple medical conditions are often not eligible to participate in the studies that inform clinical practice guidelines used in stroke rehabilitation.

Michelle says her work to understand and address this issue started with the people who use the clinical practice guidelines. “At Bridgepoint, I have the opportunity to collaborate with clinicians on the Stroke Unit. This research started with clinicians’ questions about applying clinical practice guidelines to complex patients. My work and the new research agenda we’ve developed is really a framework for conducting research that’s relevant and can inform health care providers and healthcare organizations in improving care and patient outcomes.”

The research agenda was developed with the input of 43 researchers, clinicians from many different health disciplines, and health care system leaders who all came together for a two-day think tank.

Through structured exercises the participants provided their input on setting priority research questions that will help develop a greater understanding of complex patients and their needs; how to effectively manage the needs of complex patients during stroke rehabilitation; and the outcomes of high quality care for complex rehabilitation patients. The resulting research agenda also defines questions to support decision making at the organization and health care system level.

In addition to creating a research agenda, Michelle and her colleagues used this project as an opportunity to create a complexity and stroke rehabilitation research network to enhance collaboration between researchers.

“This exercise in defining a research agenda has laid a foundation for greater collaboration between researchers across many different organizations and disciplines,” says Michelle. “Together, we’ll be able to continue refining this research agenda and building programs of research from this framework. Stroke rehabilitation stakeholders will be able to move toward an improved understanding of how to provide integrated stroke rehabilitation care for complex patients.”

The study was funded by a grant from the Canadian Institutes of Health Research (CIHR). The paper is published in the Archives of Physical Medicine and Rehabilitation. The research team is already working on further refining the research framework and getting input from additional stakeholders, including patients and family caregivers.