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

Jönsson, Ann-Cathrin LU ; Höglund, Peter LU ; Brizzi, Marco LU and Pessah-Rasmussen, Hélène LU (2014) In Journal of Stroke & Cerebrovascular Diseases 23(9). p.2287-2295
Abstract
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.... (More)
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. (Less)
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author
organization
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type
Contribution to journal
publication status
published
subject
in
Journal of Stroke & Cerebrovascular Diseases
volume
23
issue
9
pages
2287 - 2295
publisher
Elsevier
external identifiers
  • pmid:25048955
  • wos:000345649900015
  • scopus:84908021125
ISSN
1532-8511
DOI
10.1016/j.jstrokecerebrovasdis.2014.04.021
language
English
LU publication?
yes
id
6cf3eabb-8c4e-4e83-8eb5-108fb0083ab0 (old id 4581531)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/25048955?dopt=Abstract
date added to LUP
2014-08-08 23:54:04
date last changed
2017-08-06 03:20:40
@article{6cf3eabb-8c4e-4e83-8eb5-108fb0083ab0,
  abstract     = {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.},
  author       = {Jönsson, Ann-Cathrin and Höglund, Peter and Brizzi, Marco and Pessah-Rasmussen, Hélène},
  issn         = {1532-8511},
  language     = {eng},
  number       = {9},
  pages        = {2287--2295},
  publisher    = {Elsevier},
  series       = {Journal of Stroke & Cerebrovascular Diseases},
  title        = {Secondary Prevention and Health Promotion after Stroke: Can It Be Enhanced?},
  url          = {http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2014.04.021},
  volume       = {23},
  year         = {2014},
}