Secondary Prevention and Health Promotion after Stroke: Can It Be Enhanced?

Summary, in English

The aim was to study if health outcome and secondary prevention were satisfactory 1 year after stroke and if nurse-led interventions 3 months after stroke could have impact. Design was a randomized controlled open trial in a 1-year population. Primary outcome was health status 1 year after stroke. One month after stroke, survivors were randomized into intervention group (IG) with follow-up by a specialist nurse (SN) after 3 months (n = 232), and control group (CG) with standard care (n = 227), all to be followed up 1 year after stroke. At the first follow-up, patients graded their health, replied to the EuroQol-5 Dimensions (EQ-5D) health outcome questions, health problems were assessed, and supportive counseling was provided in the IG. Health problems requiring medical interventions were primarily referred to a general practitioner (GP). One year after stroke, 391 survivors were followed up. Systolic blood pressure (BP) had decreased in IG (n = 194) from median 140 to 135 (P = .05), but about half were above the limit 139 in both groups. A larger proportion (22%) had systolic BP >155 in the CG (n = 197) than in the IG (14%; P = .05). In the IG, 62% needed referrals compared with the 75% in the CG (P = .009). Forty percent in the IG and 52.5% in the CG (P = .04) reported anxiety/depression. In the IG, 75% and 67% in the CG rated their general health as fairly good or very good (P = .05). Although nurse-led interventions could have some effect, the results were not optimal. A more powerful strategy could be closer collaboration between the SN and a stroke clinician, before referring to primary care.

• Författare: Ann-Cathrin Jönsson; Peter Höglund; Marco Brizzi; Hélène Pessah-Rasmussen
• Avdelning/ar: Aktivt och hälsosamt åldrande; Avdelningen för klinisk kemi och farmakologi; Neurologi, Lund; Rehabiliteringsmedicin
• Publiceringsår: 2014
• Språk: Engelska
• Sidor: 2287-2295
• Publikation/Tidskrift/Serie: Journal of Stroke & Cerebrovascular Diseases
• Volym: 23
• Issue: 9
• Länkar: http://www.ncbi.nlm.nih.gov/pubmed/25048955?dopt=Abstract; http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2014.04.021
• Dokumenttyp: Artikel i tidskrift
• Förlag: Elsevier
• Ämne: Neurology
• Status: Published
• Forskningsgrupp: Active and Healthy Ageing Research Group; Rehabilitation medicine
• ISBN/ISSN/Övrigt: ISSN: 1532-8511