The stroke east Saxony pilot project for organized post-stroke care: a case-control study

Area of Science:

• Neurology
• Public Health
• Clinical Medicine

Background:

• Low adherence to secondary prevention guidelines post-stroke increases recurrence risk and impacts quality of life.
• Standardized post-stroke care pathways are being developed to improve patient outcomes.

Purpose of the Study:

• To determine the feasibility of a self-developed standardized post-stroke pathway.
• To assess the pathway's impact on secondary stroke prevention and long-term outcomes in acute stroke patients.

Main Methods:

• Prospective inclusion of acute stroke patients in a standardized pathway with a case manager (CM).
• Pathway included educational discussions and quarterly checkups for vascular risk factors and medication adherence.
• Comparison of outcomes at 12 months with age- and gender-matched controls receiving usual care.

Main Results:

• CM patients achieved significantly higher target goals for blood pressure, cholesterol, and body mass index compared to controls.
• CM intervention was an independent predictor of favorable functional outcome (mRS ≤ 2) at 12 months.
• CM patients reported higher quality of life, with no recurrent strokes or vascular deaths compared to controls (13.3% and 6.7% respectively).

Conclusions:

• Organized post-stroke care, facilitated by a case manager, significantly enhances secondary prevention goal achievement.
• This structured approach shows promise in reducing stroke recurrence, improving functional outcomes, and enhancing quality of life.
• Further investigation in a prospective cohort study is underway to confirm these findings.