Stroke secondary prevention, a non-surgical and non-pharmacological consensus definition: results of a Delphi study

Maggie Lawrence, Eric Asaba, Elaine Duncan, Marie Elf, Gunilla Eriksson, James Faulkner, Susanne Guidetti, Birgitta Johansson, Christina Kruuse, Danielle Lambrick, Caitlin Longman, Lena von Koch, Xu Wang, Olive Lennon

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)
98 Downloads (Pure)


Objective: Evidence supporting lifestyle modification in vascular risk reduction is limited, drawn largely from primary prevention studies. To advance the evidence base for non-pharmacological and non-surgical stroke secondary prevention (SSP), empirical research is needed, informed by a consensus-derived definition of SSP. To date, no such definition has been published. We used Delphi methods to generate an evidence-based definition of non-pharmacological and non-surgical SSP.
Results: The 16 participants were members of INSsPiRE (International Network of Stroke Secondary Prevention Researchers), a multidisciplinary group of trialists, academics and clinicians. The Elicitation stage identified 49 key elements, grouped into 3 overarching domains: Risk factors, Education, and Theory before being subjected to iterative stages of elicitation, ranking, discussion, and anonymous voting. In the Action stage, following an experience-based engagement with key stakeholders, a consensus-derived definition, complementing current pharmacological and surgical SSP pathways, was finalised: Non pharmacological and non-surgical stroke secondary prevention supports and improves long-term health and well-being in everyday life and reduces the risk of another stroke, by drawing from a spectrum of theoretically informed interventions and educational strategies. Interventions to self-manage modifiable lifestyle risk factors are contextualized and individualized to the capacities, needs, and personally meaningful priorities of individuals with stroke and their families.
Original languageEnglish
Article number823
Number of pages6
JournalBMC Research Notes
Publication statusPublished - 23 Dec 2019


  • stroke
  • secondary prevention
  • secondary prevention of stroke
  • Delphi methods
  • consensus
  • definition
  • Delphi

ASJC Scopus subject areas

  • General Biochemistry,Genetics and Molecular Biology


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