Investigating the Implementation of Community-Based Stroke Telerehabilitation in England; A Realist Synthesis Study...

Area of Science:

• Health Services Research
• Rehabilitation Medicine
• Implementation Science

Background:

• Telerehabilitation (TR) offers potential for remote healthcare delivery but lacks specific implementation guidance within England's National Health Service (NHS).
• Effective implementation is crucial for providing high-quality, equitable community-based stroke rehabilitation services.

Purpose of the Study:

• To investigate the optimal implementation of TR for community-based stroke rehabilitation within the NHS.
• To identify the conditions under which TR can support high-quality and equitable stroke care.
• To develop actionable recommendations for TR service implementation.

Main Methods:

• A realist synthesis approach will be employed.
• Data will be gathered through an evidence review and qualitative interviews with clinicians (n ≤ 30) and patient-family carer dyads (n ≤ 60).
• Co-development of recommendations with working groups including professionals, service-users, and policymakers.

Main Results:

• The study protocol aims to synthesize evidence and expert insights to refine programme theories explaining TR's effectiveness.
• It seeks to understand for whom and under what conditions TR works in clinical practice.
• Key messages for service implementation will be derived from the synthesis.

Conclusions:

• There is a need to enhance understanding of TR implementation within multidisciplinary, community-based stroke services.
• A realist methodology and co-production approach will inform evidence-based recommendations.
• Recommendations will consider the priorities of clinicians and individuals affected by stroke.