{
  "abstract": "Introduction Without guideline-based secondary management, ~10%–20% of stroke patients suffer a recurrent event within 12 months. Access to stroke specialists in rural areas is scarce, which may limit appropriate secondary prevention interventions and potentially explain the worse stroke outcomes shown in rural areas. We developed a hybrid model telestroke clinic (stroke specialist remotely by video and stroke coordinator face-to-face) at four rural hospitals in Australia. The aims were to determine the effect on recurrent cerebrovascular events, patient acceptability and cost for the hybrid clinic compared with previous usual care. We hypothesise that patients assessed through the clinic would have a decreased rate of recurrent cerebrovascular events at 12 months compared with those patients managed through standard pathways.Methods and analysis This is a retrospective, multicentre (four sites) observational service evaluation study, comparing a hybrid telestroke outpatient clinic model of care with standard care.Ethics and dissemination Ethics approval for the hybrid telestroke clinic data was obtained from the Hunter New England Human Research Ethics Committee (2021/ETH00452). Ethics approval for the control population was obtained from the Hunter New England Human Research Ethics Committee (HNEHREC Reference No. 13/02/20/5.06) with further amendment (AU201712‐15).Trial registration number ACTRN12625000447459. Registration date 13/5/2025.",
  "authors": [
    {
      "affiliations": [
        "Department of Neurology, John Hunter Hospital, New Lambton Heights, New South Wales, Australia",
        "Hunter Medical Research Institute, Newcastle, New South Wales, Australia",
        "College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, New South Wales, Australia"
      ],
      "name": "Carlos Garcia-Esperon"
    },
    {
      "affiliations": [
        "Hunter Medical Research Institute, Newcastle, New South Wales, Australia"
      ],
      "name": "Luis Mena Romo"
    },
    {
      "affiliations": [
        "College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, New South Wales, Australia"
      ],
      "name": "Heidi Janssen"
    },
    {
      "affiliations": [
        "Hunter Medical Research Institute, Newcastle, New South Wales, Australia"
      ],
      "name": "Md Golam Hasnain"
    },
    {
      "affiliations": [
        "South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia"
      ],
      "name": "Dante Dangelo-Kemp"
    },
    {
      "affiliations": [
        "Tamworth Hospital, Hunter New England Local Health District, Tamworth, New South Wales, Australia"
      ],
      "name": "Rachel Peake"
    },
    {
      "affiliations": [
        "Armidale Hospital, Hunter New England Local Health District, Tamworth, New South Wales, Australia"
      ],
      "name": "Jaclyn Birnie"
    },
    {
      "affiliations": [
        "Manning Base Hospital, Hunter New England Local Health District, Taree, New South Wales, Australia"
      ],
      "name": "Emma Mccartney"
    },
    {
      "affiliations": [
        "Manning Base Hospital, Hunter New England Local Health District, Taree, New South Wales, Australia"
      ],
      "name": "Priya Jacob"
    },
    {
      "affiliations": [
        "John Hunter Hospital Department of Neurology, Newcastle, New South Wales, Australia"
      ],
      "name": "Beng Lim Alvin Chew"
    },
    {
      "affiliations": [
        "Hunter Stroke Services, Hunter New England Local Health District, New Lambton, New South Wales, Australia"
      ],
      "name": "Simone Owen"
    },
    {
      "affiliations": [
        "Department of Neurology, John Hunter Hospital, New Lambton Heights, New South Wales, Australia"
      ],
      "name": "Thomas Ottavi"
    },
    {
      "affiliations": [
        "College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, New South Wales, Australia"
      ],
      "name": "Chehakprit Kaur"
    },
    {
      "affiliations": [
        "Sydney Medical School, Nepean Hospital, Penrith, New South Wales, Australia"
      ],
      "name": "Kevin Hou"
    },
    {
      "affiliations": [
        "Tamworth Hospital, Hunter New England Local Health District, Tamworth, New South Wales, Australia"
      ],
      "name": "Lisa Dark"
    },
    {
      "affiliations": [
        "Department of Neurology, John Hunter Hospital, New Lambton Heights, New South Wales, Australia"
      ],
      "name": "Christopher R Levi"
    },
    {
      "affiliations": [
        "Department of Neurology and Neurophysiology, Liverpool Hospital, Liverpool, New South Wales, Australia",
        "University of New South Wales, Sydney, New South Wales, Australia",
        "Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia"
      ],
      "name": "Mark W Parsons"
    },
    {
      "affiliations": [
        "Department of Neurology, John Hunter Hospital, New Lambton Heights, New South Wales, Australia",
        "Hunter Medical Research Institute, Newcastle, New South Wales, Australia",
        "College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, New South Wales, Australia"
      ],
      "name": "Neil Spratt"
    },
    {
      "affiliations": [],
      "name": "on behalf of HNE Telestroke Clinic Group"
    }
  ],
  "title": "Comprehensive evaluation of telehealth outpatient stroke service in rural and remote Australia: a multicentre study protocol",
  "uid": "baae9aae-6c44-581c-afaa-5b9630b36979"
}