Comprehensive quality assessment for aphasia rehabilitation after stroke: protocol for a multicentre, mixed-methods study

Sam Harvey; Marissa Stone; Sally Zingelman; David A Copland; Monique F Kilkenny; Erin Godecke; Dominique A Cadilhac; Joosup Kim; Muideen T Olaiya; Miranda L Rose; Caterina Breitenstein; Kirstine Shrubsole; Robyn O'Halloran; Annie J Hill; Deborah Hersh; Kathryn Mainstone; Penelope Mainstone; Carolyn A Unsworth; Emily Brogan; Kylie J Short; Clare L Burns; Caroline Baker; Sarah J Wallace

doi:10.1136/bmjopen-2023-080532

Comprehensive quality assessment for aphasia rehabilitation after stroke: protocol for a multicentre, mixed-methods study

BMJ Open. 2024 Mar 21;14(3):e080532. doi: 10.1136/bmjopen-2023-080532.

Authors

Sam Harvey^{1

2}, Marissa Stone^{3

4}, Sally Zingelman^{3

2}, David A Copland^{3

2}, Monique F Kilkenny^{5

6}, Erin Godecke^{7

8}, Dominique A Cadilhac^{5

6}, Joosup Kim^{6

9}, Muideen T Olaiya⁵, Miranda L Rose^{8

10}, Caterina Breitenstein¹¹, Kirstine Shrubsole^{3

12}, Robyn O'Halloran^{8

10}, Annie J Hill^{8

10}, Deborah Hersh^{13

14}, Kathryn Mainstone³, Penelope Mainstone³, Carolyn A Unsworth^{5

15}, Emily Brogan^{16

17}, Kylie J Short², Clare L Burns¹⁸, Caroline Baker^{8

19}, Sarah J Wallace^{3

2}

Affiliations

¹ Queensland Aphasia Research Centre, The University of Queensland, Saint Lucia, Queensland, Australia sam.harvey@uq.edu.au.
² Surgical, Treatment and Rehabilitation Service Education and Research Alliance, The University of Queensland and Metro North Hospital and Health Service, Herston, Queensland, Australia.
³ Queensland Aphasia Research Centre, The University of Queensland, Saint Lucia, Queensland, Australia.
⁴ St Vincent's Hospital Melbourne Pty Ltd, Fitzroy, Victoria, Australia.
⁵ Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
⁶ Stroke Theme, The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia.
⁷ School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.
⁸ Centre for Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Victoria, Australia.
⁹ Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.
¹⁰ School of Allied Health, Human Services and Sport, La Trobe University College of Science Health and Engineering, Bundoora, Victoria, Australia.
¹¹ Department of Neurology with Institute of Translational Neurology, University of Muenster, Muenster, Germany.
¹² Metro South Hospital and Health Service, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
¹³ Curtin School of Allied Health and EnAble Institute, Curtin University, Perth, Western Australia, Australia.
¹⁴ Australian Aphasia Association, Perth, Western Australia, Australia.
¹⁵ Institute of Health and Wellbeing, Federation University, Ballarat, Victoria, Australia.
¹⁶ Edith Cowan University, Joondalup, Western Australia, Australia.
¹⁷ Fiona Stanley Fremantle Hospitals Group, South Metropolitan Health Service, Palmyra, Western Australia, Australia.
¹⁸ Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, Queensland, Australia.
¹⁹ Speech Pathology Department, Monash Health, Clayton, Victoria, Australia.

Abstract

Introduction: People with aphasia following stroke experience disproportionally poor outcomes, yet there is no comprehensive approach to measuring the quality of aphasia services. The Meaningful Evaluation of Aphasia SeRvicES (MEASuRES) minimum dataset was developed in partnership with people with lived experience of aphasia, clinicians and researchers to address this gap. It comprises sociodemographic characteristics, quality indicators, treatment descriptors and outcome measurement instruments. We present a protocol to pilot the MEASuRES minimum dataset in clinical practice, describe the factors that hinder or support implementation and determine meaningful thresholds of clinical change for core outcome measurement instruments.

Methods and analysis: This research aims to deliver a comprehensive quality assessment toolkit for poststroke aphasia services in four studies. A multicentre pilot study (study 1) will test the administration of the MEASuRES minimum dataset within five Australian health services. An embedded mixed-methods process evaluation (study 2) will evaluate the performance of the minimum dataset and explore its clinical applicability. A consensus study (study 3) will establish consumer-informed thresholds of meaningful change on core aphasia outcome constructs, which will then be used to establish minimal important change values for corresponding core outcome measurement instruments (study 4).

Ethics and dissemination: Studies 1 and 2 have been registered with the Australian and New Zealand Clinical Trial Registry (ACTRN12623001313628). Ethics approval has been obtained from the Royal Brisbane and Women's Hospital (HREC/2023/MNHB/95293) and The University of Queensland (2022/HE001946 and 2023/HE001175). Study findings will be disseminated through peer-reviewed publications, conference presentations and engagement with relevant stakeholders including healthcare providers, policy-makers, stroke and rehabilitation audit and clinical quality registry custodians, consumer support organisations, and individuals with aphasia and their families.

Keywords: Observational Study; Quality in health care; Stroke.

MeSH terms

Aphasia* / rehabilitation
Australia
Female
Humans
Multicenter Studies as Topic
Pilot Projects
Quality of Life
Stroke Rehabilitation*
Stroke* / complications
Stroke* / therapy