Development of Enhanced Reviews of Psychological Changes After Stroke (ENRICH): A complex Intervention to Monitor and Support Self-Management of Post-Stroke Psychological Changes Within a Matched Care Model.

ObjectiveTo report the design and development of a complex intervention to monitor and support self-management of post-stroke psychological changes.DesignThe Medical Research Council framework for complex intervention research guided development work, which included a literature review, semi-structured interviews with stroke survivors (n = 26) and family members (n = 11), a Delphi survey with healthcare professionals and researchers (n = 42), and workshops with stroke survivors (n = 4), family members (n = 3), and healthcare professionals (n = 5).SettingStroke community care.ParticipantsStroke survivors, family members, healthcare professionals and researchers.InterventionThe Enhanced Reviews of Psychological Changes after stroke (ENRICH) programme is a brief intervention deliverable within the UK matched care model of post-stroke psychological support. It supports stroke survivors with mild to moderate cognitive changes, low mood, anxiety and fatigue by monitoring symptoms, providing personalised psychoeducation, and supporting self-management through three brief reviews at 1, 3, and 6 months. Those with more severe or persistent psychological changes are referred through local care pathways for specialist psychological input.Main measuresThe intervention is reported using the TIDieR checklist.ResultsThe logic model and programme theory suggest benefits for psychological wellbeing and quality of life, with stakeholder input likely to enhance acceptability and feasibility.ConclusionsENRICH has the potential to address gaps in UK post-stroke care for those with mild to moderate changes affecting cognition, mood, anxiety and fatigue when delivered within the matched care model. Feasibility testing is underway with future clinical effectiveness testing is planned.