Poster Presentation Asia Pacific Stroke Conference 2024

Strategies for overcoming recruitment and retention challenges in the Trial of an Individualized Intervention for the Prevention of Stroke (TIIPS) Study (#374)

Jesse Dyer 1 , Rita Krishnamurthi 1 , Sulekha Devaki De Silva 1 , Balakrishnan Nair 1 , Derrick Bennett 2 , Braden Te Ao 3 , Alan Barber 4 , Yogini Ratnasabapathy 5 , Suzanne Barker-Collo 6 , Irene Zeng 7 , Valery Feigin 1
  1. National Institute for Stroke and Applied Neurosciences, AUT University, Auckland, Auckland, AUCKLAND, New Zealand
  2. Nuffield Department of Population Health, University of Oxford , Oxford, United Kingdom
  3. School of Population Health, The University of Auckland, Auckland, New Zealand
  4. University Research Centre for Brain Research, The University of Auckland, Auckland, New Zealand
  5. Waitemata, Stroke Units, Geriatrics, Waitakere Hospital, Te Whatu Ora - Waitemata, Auckland, New Zealand
  6. School of Psychology, University of Auckland, Auckland, New Zealand
  7. Faculty of Medical and Health Sciences, Auckland University of Technology, Auckland, New Zealand

Background:  The Trial of an Individualized Intervention for the Prevention of Stroke (TIIPS) study is evaluating the efficacy of Health Coaching and the Stroke Riskometer TM for secondary prevention after TIA/minor stroke. We aim to describe challenges to recruitment and how these were addressed.

Methods: The TIIPS RCT aims to 360 adults aged ≥18 years with recent TIA/minor stroke from public hospitals in New Zealand. Initially, the recruitment rate (10%) was lower than anticipated (20%), due to a large proportion of ineligible participants. Detailed documentation of reasons for exclusion informed strategies to improve recruitment; removing the upper age cut-off; relaxing the blood pressure (BP) and cognitive impairment cut-off; inclusion of recurrent stroke and heart attack; and increased timeframe of inclusion to 90 days post event. An additional recruitment site is planned in 2024.

Results: Since the relaxation of the inclusion criteria, the recruitment rate improved from 10% in December 2022 to 25% now. We recruited n= 57 people over 75 years, n=26 with systolic BP between 120 and 130 and on BP medication, n=53 with a lower cognitive impairment score, n=20 with recurrent stroke and heart attack.  In total, 156 more people (65% of total randomised) met the criteria that would have been previously ineligible. None have reported difficulties with participation.

Discussion: Relaxation of the inclusion criteria has improved the recruitment rate of the trial. As an added benefit, the findings of the study are now applicable to a wider range of stroke patients for secondary prevention.