Stroke is an important health issue in Ireland. Over 5,500 adults were admitted to acute hospitals following stroke in 2020, 71% of whom were discharged home with a documented disability. By 2035 a 34% increase in total stroke events in the EU is expected and by 2047 a 27% rise in prevalent cases in the community is projected. While most experience functional improvement during the first after stroke, the functional level achieved 3-6 post-stroke is strongly associated with long-term outcome. Currently, ~80% of all stroke survivors are discharged home, with a significant number dependent on practical and emotional support. Despite ever-growing numbers of individuals living with the consequences of stroke, no robust evidence supports different approaches or models of care after stroke and no consensus is evident on what is meant by long-term survival. The Burden of Stroke in Europe Report clearly documents the everyday plight for many survivors and their families under four overlapping categories: health issues, activity issues, adjustment and wellbeing, and information and support issues. There has been a persistent failure by Irish health authorities to establish the prevalence of stroke survivors in the country, as a minimal starting point. Previously documented unmet needs in life after stroke in Ireland include healthcare services, social care and other supports with low satisfaction rates with the help available for these problems. This proposal will address key knowledge gaps in life after stroke by seeking to: (1) identify existing mechanisms that can successfully address long-term needs after stroke using a rapid realist review, (2) identify the prevalence of stroke at a population level (3) identify the priorities to be addressed in life after stroke by stroke survivors and (4) engage key stakeholders in the co-design and cost of a care pathway to best support life after stroke.
