Stroke survivors' perspectives on decision-making about rehabilitation and the prospect of taking recovery-promoting drugs: A qualitative study

You managed to miss all these drugs for stroke recovery. Don't you read the literature?

• DMT (8 posts to November 2020)

• ecstasy (19 posts to November 2012)

• LSD (5 posts to September 2018)

  • CerAxon (5 posts to January 2012)

  • citicoline (15 posts to October 2011)

   

• magic mushrooms (10 posts to October 2014) 

  psilocybin (14 posts to May 2014)

  My 13 reasons for marijuana use post-stroke.  

  Don't follow me, I'm not medically trained and I don't have a Dr. in front of my name.

   

 

Stroke survivors' perspectives on decision-making about rehabilitation and the prospect of taking recovery-promoting drugs: A qualitative study

Author links open overlay panel

, , , ,

https://doi.org/10.1016/j.rcsop.2023.100297Get rights and content

Under a Creative Commons license

open access

Abstract

Objectives

To investigate factors which influence stroke survivors' decision-making about their rehabilitation and the prospect of taking recovery-promoting drugs, to enhance their recovery.

Methods

Seventeen stroke survivors who had undertaken stroke rehabilitation, and three spouses, participated in focus groups and individual interviews in northern Queensland, Australia. Inductive thematic analysis of the interview data was conducted in accordance with Braun and Clarke's six-phase process.

Results

Two specific, pivotal decision points during participants' stroke recovery process were identified: 1) overall, when deciding what rehabilitation they would undertake and hypothetically what recovery-promoting drugs they would take, and 2) on a daily basis, when deciding whether to participate in rehabilitation and take recovery-promoting drug on any given day. Six themes which described factors influencing their decision-making were: ‘My options for rehabilitation and recovery-promoting drugs’; ‘The costs of rehabilitation and recovery-promoting drugs’; ‘My recovery goals’; ‘What I can deal with today’; ‘The people my rehabilitation and recovery-promoting drugs affect’; and ‘Fitting rehabilitation and recovery-promoting drugs into my life.’ These themes were applicable at either one or both of the identified decision points.

Conclusion

Factors that influence stroke survivors' decision-making, overall and on a day-to-day basis, need to be considered to ensure they can make the best decisions for themselves to achieve their full recovery potential. Understanding the conditions under which a stroke survivor would take a recovery-promoting drug will contribute to the development of dosing protocols to which stroke survivors could adhere.

Keywords

Stroke

Rehabilitation

Recovery

Pharmacotherapy

Medication

Drug

1. Introduction

Stroke survivor preferences with regard to the costs, risks and inconveniences associated with rehabilitation interventions to improve their recovery play an important role in whether they choose to adhere to the intervention.1., 2., 3. For example, the cost of transport to the rehabilitation clinic, the risk of falling while transiting and the inconvenience of waiting to be collected after an appointment are all factors which may affect adherence. Such factors must be considered with the advent of recovery-promoting drugs (RPDs), defined as medications that promote motor recovery post-stroke.^4,5 To date, drugs investigated for recovery-promoting potential have included amphetamine, cerebrolysin, citalopram, fluoxetine, lithium and selegilene.⁸ The conditions under which stroke survivors would commit to taking RPDs as prescribed are largely unknown. Understanding their preferences, and the factors that underpin them, is necessary if clinicians are to support stroke survivors to make informed decisions about RPDs that they would take precisely as prescribed to maximise their recovery.³ Furthermore, accommodating stroke survivors' preferences for physical and behavioural rehabilitation interventions (referred to as rehabilitation hereafter) and RPDs, alone or in combination, has potential to improve trial fidelity and translation into real-world practice.⁹ This knowledge could contribute to the development of robust clinical guidelines for RPD use to promote stroke recovery.

Stroke survivor preferences are influenced by many and varied factors, each of which hold varying importance to each individual .^1,3 Discrete choice experiments allow investigation into the interplay of such factors that may influence a person's preference by examining the trade-offs respondents are willing to make between different key attributes in decision-making.¹⁰ While several DCEs have been undertaken to investigate stroke survivors' preferences for rehabilitation and for medications to reduce stroke risk,^3,11., 12., 13., 14. none have been conducted to explore stroke survivors' decision-making about their rehabilitation and prospect of taking recovery-promoting drugs. When developing a robust discrete choice experiment, the key factors influencing decision-making must be known.¹⁵ Because RPDs have only been used in clinical trials, finding stroke survivors with experience taking them is near impossible. Until such time as RPDs are routinely available or prescribed, exploring how stroke survivors make decisions about their participation in rehabilitation will provide important insight into these factors. By posing the hypothetical question of whether they would take RPDs, and under what circumstances, stroke survivors can draw on their lived experience of making decisions to promote their recovery and provide their best estimation of which factors would influence their decision-making. Therefore, the aim of this study was to investigate factors which would influence stroke survivors' decision-making about their rehabilitation, and the prospect of taking RPDs, to enhance their recovery.

More at link.