Annals of Indian Academy of Neurology (Jan 2022)

Study Protocol: IMPETUS: Implementing a uniform stroke care pathway in medical colleges of India: IMPETUS Stroke

  • Rohit Bhatia,
  • Partha Haldar,
  • Inder Puri,
  • M V Padma Srivastava,
  • Sanjeev Bhoi,
  • Menka Jha,
  • Anupam Dey,
  • Suprava Naik,
  • Satyabrata Guru,
  • Mamta Bhushan Singh,
  • V Y Vishnu,
  • Roopa Rajan,
  • Anu Gupta,
  • Deepti Vibha,
  • Awadh Kishore Pandit,
  • Ayush Agarwal,
  • Manish Salunkhe,
  • Gunjan Singh,
  • Deepshikha Prasad,
  • Samhita Panda,
  • Sucharita Anand,
  • Amit Kumar Rohila,
  • Pushpinder S Khera,
  • Sarbesh Tiwari,
  • S Bhaskar,
  • Mayank Garg,
  • Niraj Kumar,
  • Minakshi Dhar,
  • Ashutosh Tiwari,
  • Naman Agrawal,
  • Garuda Buchi Raju,
  • Jyoti Garg,
  • Biman Kanti Ray,
  • Amit Bhardwaj,
  • Alok Verma,
  • Nikhil Dongre,
  • Gurpreet Chhina,
  • Raminder Sibia,
  • Rupinderjeet Kaur,
  • Paresh Zanzmera,
  • Amit Gamit,
  • Thomas Iype,
  • Ravinder Garg,
  • Sulena Singh,
  • Ashok Kumar,
  • Abhay Ranjan,
  • Vijay Sardana,
  • Dilip Soni,
  • Bharat Bhushan,
  • Rajinder K Dhamija,
  • Alvee Saluja,
  • Kiran Bala,
  • Surekha Dabla,
  • Divya Goswami,
  • Abhimanyu Agarwal,
  • Sudhir Shah,
  • Shalin Shah,
  • Mayank Patel,
  • Pranav Joshi,
  • Sanjiv Awasthi,
  • Smita Nath,
  • Shishir Chandan,
  • Rupali Malik,
  • Neera Chowdhury

DOI
https://doi.org/10.4103/aian.aian_1033_21
Journal volume & issue
Vol. 25, no. 4
pp. 640 – 646

Abstract

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Introduction: In India, a national program for stroke (national programme for the control of cardiovascular diseases, diabetes, cancer, and stroke) and stroke management guidelines exist. Its successful implementation would need an organized system of stroke care in practice. However, many challenges exist including lack of awareness, prehospital notification systems, stroke ready hospitals, infrastructural weaknesses, and rehabilitation. We present here a protocol to investigate the feasibility and fidelity of implementing a uniform stroke care pathway in medical colleges of India. Methods and Analysis: This is a multicentric, prospective, multiphase, mixed-method, quasi-experimental implementation study intended to examine the changes in a select set of stroke care-related indicators over time within the sites exposed to the same implementation strategy. We shall conduct process evaluation of the implementation process as well as evaluate the effect of the implementation strategy using the interrupted time series design. During implementation phase, education and training about standard stroke care pathway will be provided to all stakeholders of implementing sites. Patient-level outcomes in the form of modified Rankin Scale score will be collected for all consecutive patients throughout the study. Process evaluation outcomes will be collected and reported in the form of various stroke care indicators. We will report level and trend changes in various indicators during the three study phases. Discussion: Acute stroke requires timely detection, management, and secondary prevention. Implementation of the uniform stroke care pathway is a unique opportunity to promote the requirements of homogenous stroke care in medical colleges of India.

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