The effectiveness of interventions to support informal stroke carers: a systematic review

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Abstract
Stroke affects one in four adults in the UK, with over a third relying on informal carers. The burden of care can have detrimental effects on the mental and physical health of carers, which may impact the rehabilitative process. Despite this, interventions have focused on the physical demands of caregiving, prioritising the stroke survivor. This review aimed to identify effective psychosocial interventions that reduce burden, strain, depression, or anxiety in informal stroke carers. A systematic review of the literature was conducted using MEDLINE, EMBASE, PsycINFO, the Cochrane Library, and PubMed, with final searches on the 8th May 2025. Randomised controlled trials (RCTs) published in English from 1980 onwards, including participants aged 18 years or older, were eligible. Risk of bias was assessed using the CASP tool for RCTs. Results were reported using narrative synthesis. Seven studies were rated as having good methodological quality, fourteen moderate, and three weak. Fourteen studies reported significant findings. Interventions varied widely, with characteristics of effective interventions including skills-based problem-solving content, telephone delivery, longer duration, and increased contact time. Providing remote support over extended durations may improve the psychological well-being of informal stroke carers. Tentative conclusions are presented, and further research is required.

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