Moderated Poster Australian and New Zealand Stroke Organisation Conference 2025

Co-design of a digital tool for remote monitoring of stroke survivors by general practice: A modified Delphi process (123186)

Muideen T Olaiya 1 , Rosanne Freak-Poli 1 , Tara Purvis 1 , Sarah J Wallace 2 3 , Lauren M Sanders 4 5 , Mark R Nelson 6 , Dominique A Cadilhac 1 7 , Jared Slater 8 , Tharshanah Thayabaranathan 1 , Jan Cameron 1 , Clive Kempson 9 , Samiksha Dhananjay 1 , Kennice Tan 1 , Monique F Kilkenny 1 7
  1. Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
  2. Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Herston, Queensland, Australia
  3. Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, Herston, Queensland, Australia
  4. St Vincent’s Hospital, Melbourne, Victoria, Australia
  5. Department of Medicine, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
  6. Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
  7. Stroke Theme, Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Heidelberg, Victoria, Australia
  8. Gippsland Primary health Network, Traralgon, Victoria, Australia
  9. Department of Occupational Therapy, School of Primary and Allied Health Care, Monash University, Frankston, Victoria, Australia

Background: Remote monitoring via digital tools could enable continuous communication of care needs (e.g., risk factors/symptoms) directly between stroke survivors and general practice. To enhance engagement, it is essential that digital monitoring tools meet the needs of end-users (survivors/support persons, GPs, nurses).

Aim: To co-design a tool for use in a general practice digital platform to remotely monitor stroke survivors.

Methods: A modified Delphi approach involving: (1) systematic review of care needs post-stroke; (2) priority-setting survey for survivors/support persons to rank these needs based on importance in stroke recovery, needs that should trigger a medical alert, and final top-five priority needs; (3) separate focus groups with health experts (2 GPs, 1 neurologist, 2 nurses, 1 allied health) and people with lived experience (5 survivors, 3 support persons) to achieve consensus on priority needs.

Results: Fifty-nine care needs were identified in the systematic review. These were ranked in a survey by 57 survivors (49% aged ≥60 years, 61% female, 31% from rural/regional areas) and 10 support persons (49% aged ≥60 years, 90% female). In focus group discussions of the top 15 ranked needs from the survey, priorities differed between health experts and survivors/support persons. Consensus was achieved for the top 8 needs to be monitored (blood pressure, support services, atrial fibrillation, cognition, emotions/mental health, speech/communication, fatigue, stroke-related information). Other needs in the top 15 were mobility/physical activity, study/work, diet, weight, exercise, headaches, and managing daily activities.

Conclusion: We identified eight care needs as priorities for digital remote monitoring by general practice.