Poster Presentation Australian and New Zealand Stroke Organisation Conference 2025

Lessons learned from a trial examining community, group-based education for the management of post-stroke fatigue: the FASTER trial (#134)

Sulekha Devaki De Silva 1 , Rita Krishnamurthi 1 , Suzanne Barker-Collo 2 , Valery Feigin 1 , Geoff Green 3 , Yogini Ratnasabapathy 4 , Braden Te Ao 5 , Irene Zeng 6 , Kelly Jones 1
  1. National Institute for Stroke and Applied Neurosciences, AUT, Auckland, New Zealand
  2. School of Psychology, The University of Auckland, Auckland, New Zealand
  3. Services for Older People, Te Whatu Ora–Health, New Zealand Counties Manukau, Auckland, New Zealand
  4. Waitemata, Integrated Stroke Unit, Stroke Services, Waitakere Hospital, Te Whatu Ora - Waitemata,, Auckland, New Zealand
  5. School of Population Health, The University of Auckland, Auckland, New Zealand
  6. Department of Biostatistics and Epidemiology, Auckland University of Technology, Auckland, New Zealand

Background:

Post-stroke fatigue (PSF) is common and significantly affects quality of life. The ‘Fatigue After Stroke Educational Recovery’ (FASTER) study, a multicentre, phase 3 randomised controlled trial, evaluated a community-based, multiple-session group psychoeducation programme for PSF management.

 

Aim:
To share key lessons learned from implementing the FASTER trial.

 

Method:
Between August 2019 and March 2022, adults (n=200) with clinically significant PSF and their caregivers were recruited across the Auckland and Waikato regions of New Zealand. Participants were randomised to either a general stroke education/control session (EC) or a six-week Fatigue Management Group (FMG) intervention. In total, 33 group sessions were delivered at 20 venues (Auckland n=22, Waikato n=11), including four online sessions due to COVID-19. The research team reflected on learnings from conducting the trial that facilitated or challenged recruitment, participation, and retention of participants.

 

Results:
Organisational enablers included (1) flexible scheduling of group sessions, (2) strong coordination among therapists and participants, and (3) funded transportation. Individual-level supports involved (1) therapist management of varying PSF levels and co-morbidities, (2) aphasia-friendly communication, and (3) technical support for online access. Environmental factors that supported participation included accessible, calming community venues (e.g., lie-down facilities, refreshments). Challenges included the logistics of scheduling group sessions across broad regions, accommodating diverse participant needs within groups, and the re-administration of key baseline measures to mitigate delays to groups starting.

 

Conclusion:

Lessons from the FASTER trial highlight important considerations for the future design and implementation of inclusive, community-based interventions to better support adults with PSF and their caregivers.