Stroke and Older People’s Research

The Stroke and Older People’s Research team are located in the Clinical Practice Research Unit (CPRU), the only nurse led stroke research unit in the UK. This prolific and experienced multi-disciplinary team of researchers, led by Professor Caroline Watkins, delivers programmatic pure and applied research across several domains. The team has a national, and growing international, stroke research profile. Not only is the team increasing the evidence-base for stroke care, but it is also facilitating  implementation of research evidence into practice. The team is committed to increasing understanding of research, and NHS research capability, and this is apparent from the number of clinicians participating in research training and postgraduate degrees.

The extensive portfolio of primary and secondary research spans the four main areas of stroke care (acute, rehabilitation, prevention and community). A key tenet is to not just understand what must be done, but how it can be implemented – practically: by fostering clinical engagement and understanding service models and the context of care delivery: and theoretically: by appreciating behaviour change from an individual, and organisational, perspective.  Evidence of the former is apparent through involvement at a local level - in development of clinical (North West Stroke Task Force) and research (Local Research Network for Stroke) networks - and at a national level (Department of Health National Stroke Strategy and Stroke Research Network Clinical Study Groups).  Evidence of the latter is from our research portfolio.

Acute Care: Recent prestigious funding for programmatic research (> £1 million) from the Department of Health, National Institute for Health Research, will allow the development of emergency stroke pathways, raising the profile of stroke as a medical emergency, whilst establishing an evidence-base for acute care.

Rehabilitation: Programmatic research is also being developed, and an evidence-base pursued, for stroke rehabilitation.  For example, the team has an emergent international reputation for exploring the psychosocial impact of stroke, this is evidenced by ground-breaking research demonstrating, for the first time, that a talk-based therapy (motivational interviewing) could prevent and treat depression post-stroke, and also protect against death. The results are being incorporated into a systematic review of studies on the prevention of depression, and an application for multi-centre trials with colleagues in Australia.

Prevention and Community Care: The team has developed innovative mechanisms for delivering and evaluating community dissemination of key stroke-related public health messages involving people with stroke, and their families across a range of communities, including minority ethnic groups.

Building on success in involving users and carers in all research processes, the team is expanding its expertise in systematic review, meta-analysis, assessment of organisational context, epidemiological and economic modelling to provide further evidence to support and inform implementation.

The current portfolio of research is supported by a robust platform of developmental research work. Information gained from systematic reviews, economic modelling and substantial comprehensive pilot, feasibility, and single-centre research is informing protocols for large multi-centre studies.  Multi-centre trials will be facilitated by NHS and academic partners working in partnership. We will not only undertake collaborative research, but by taking account of, and understanding, organisational context and user perspectives, will ensure that results are translated into real benefits for patients and their carers, as well as the health and social care system.