Effectiveness of information and communications technology interventions for stroke survivors and their support people: a systematic review

Abstract

Purpose

To examine the effectiveness of self-directed, off-the-shelf information and communications technology (ICT)-based interventions in improving the quality of life, physical and psychosocial outcomes of community-dwelling stroke survivors and their support persons (SP).

Methods

Medline, EMBASE, CINAHL and Cochrane databases were searched (2006–19th June 2020) for randomized controlled trials, controlled trials, controlled before and after studies, or interrupted time series studies that met the eligibility criteria. The quality of included studies was assessed. Interventions effectiveness was narratively synthesized, as was participant adherence and acceptability.

Results

Seventeen studies were eligible. Three studies were rated as low risk of bias across all methodological review criteria. Nine studies reported on interventions delivered using self-directed computer programs, two studies utilized internet or web-based support programs and six studies used mobile phone interventions. Few studies reported on intervention acceptability or adherence. Those that did generally reported good acceptability, although adherence was variable. Fifteen studies reported significant positive effects for at least one outcome examined including stroke-specific outcomes, physical outcomes, behavioural outcomes and health service use. No studies found an effect for psychosocial wellbeing.

Conclusion

ICT-based interventions are likely to provide benefit to stroke survivors and their SPs. However, there is a need for further robustly designed intervention studies that include larger sample sizes, longer follow-up, and outcomes for SPs.

Implications for Rehabilitation

• ICT-based interventions with minimal clinician supervision are likely to provide some benefits to stroke survivors and their SPs.

• There is insufficient evidence to allow recommendations to rehabilitation professionals regarding the type, length and intensity of ICT-based interventions for specific targeted outcomes.

• Rehabilitation professionals should use professional judgement prior to recommending ICT-based interventions to stroke survivors and their SPs.

Keywords:

• Telephone
• internet
• systematic review
• caregivers
• ambulatory care
• computer

Disclosure statement

The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Additional information

Funding

This study was supported by a National Health and Medical Research (NHMRC) Partnership Grant [APP1114511] and by infrastructure funding from the Hunter Medical Research Institute. Megan Freund was supported by a NHMRC Translating Research Into Practice Fellowship [APP1132839] and Mariko Carey is supported by Boosting Dementia Research Leadership Fellowship [APP1136168].