Following the success of the CACTUS pilot study, we are investigating the process of implementing the intervention into clinical practice in Sheffield Teaching Hospitals.
In speech and language therapy locally, patients with aphasia receive 12 weeks of intensive (often daily) services from the Community Intermediate Care Team following hospital discharge. After this, some may be referred for ongoing community speech and language therapy within teams who can provide support at a lower intensity (weekly). Central to CACTUS is the use of technology to be able to continue to deliver treatment intensively for as long as the patient is likely to benefit from it, as recommended in the National Stroke Strategy (2005). The findings from the CACTUS project are therefore now being implemented within STH to extend the current stroke pathway. The new pilot service is known as CACTi (Cost effective aphasia computer therapy implemented). We are following Ian Grahams implementation model to guide the process of tailoring and setting up the new service. This includes tailoring the intervention to local need and identifying facilitators and barriers to providing the service.
The new pilot service received its first referrals in November 2012. Between November 2012 and April 2013, 11 patients have been referred to CACTi for intensive self-managed aphasia therapy using computer software. The service is offered for three months in the first instance. So far, 5 patients have completed their three months of therapy, self-managing over 100 hours of therapy between them. Four of the 5 patients have shown improvements on outcome measures.
A 12 month service evaluation is underway and useful outcome measures were selected through discussion with a local commissioner. The first 6 months of the service evaluation data will be reported to the commissioners in early autumn, along with costings for a proposed service.
For more information please contact Dr Rebecca Palmer