How should we evaluate the effectiveness of rehabilitation for persisting cognitive problems post stroke? Progress developing a new patient-reported outcome measure.

Introduction: The Department of Health increasingly recognises theimportance of patient-reported outcome measures (PROMS) to evaluateinterventions, particularly for chronic conditions where rehabilitationmay target social, psychological and emotional, as well as physical healthdomains. This abstract describes two completed studies in the development of a patient-reported outcome measure for persisting post-strokecognitive problems.Method: 1) Systematic literature review identifying and critically appraising PROMs for cognition. 2) Qualitative study interviewing service users(N = 16) and carers (N = 15) exploring impacts of cognitive problems thatshould be measured.Results: 1) 4,000 abstracts were reviewed with 133 PROMs identified; 23tools that examined cognitive function broadly were critically appraised.Tools that were not considered further were generic activities of dailyliving (ADL)/quality of life (QoL) scales or impairment-specific scales. Notools met the aims of being comprehensive for cognition whilst examiningthe specific impacts of cognitive problems (rather than general ADL/QoLissues). 2) Themes include (i) altered lives (ii) changes in self and relationships (iii) testing for ‘norms’ and (iv) insight. The interview data havedetermined content for the first draft of the measure and relevant components of identified tools have been adapted to influence the itemwording.Conclusion: Existing measures that are not impairment-specific do notcapture the consequences of cognitive impairment following strokedescribed by survivors and their carers. This study demonstrates a mixedmethods, patient-centred approach to develop a measure that will besuitable to evaluate the effectiveness of interventions for persisting poststroke cognitive problems. Up to date draft versions of the measure will bepresented at the UKSF.