Cochrane review: information provision for stroke patients and their caregivers

Abstract

Objective: To assess the effectiveness of information provision strategies in improving the outcome for stroke patients and/or their identified caregivers. Data sources: We searched: the Cochrane Stroke Group Trials Register; the Cochrane Central Register of Controlled Trials; electronic databases MEDLINE; EMBASE; CINAHL; PsycINFO; Science Citation Index and Social Science Citation Index; Assia; Index to UK theses; Dissertation Abstracts; ongoing trials and research registers; bibliographies of retrieved papers, relevant articles, and books; the Journal of Advanced Nursing. We also contacted researchers for additional information. Review methods: Two review authors independently assessed trial eligibility, extracted data and assessed methodological quality. Primary outcomes were knowledge about stroke and impact on mood. Meta-analyses were undertaken for the domains of knowledge, mood, satisfaction, and mortality. Results: Seventeen trials were identified and 11 contributed data to the meta-analyses. There were significant effects in favour of the intervention on patient knowledge (standardized mean difference (SMD) 0.29, 95% confidence interval (CI) 0.12 to 0.46), caregiver knowledge (SMD 0.74 95% CI 0.06 to 1.43), patient depression scores (weighted mean difference (WMD) -0.52, 95% CI -0.93 to -0.10), and one aspect of patient satisfaction (odds ratio (OR) 2.07, 95% CI 1.33 to 3.23). Post-hoc subgroup analyses showed that strategies which actively involved patient and caregivers had a significantly greater effect on patient anxiety (P<0.05) and depression (P<0.02) than passive strategies. Conclusion: There is some evidence to support the routine provision of information to stroke patients and their families. Although the best way to provide information is still not clear, the results of this review suggest that strategies which actively involve patients and caregivers should be used in routine practice.