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Published on: February 22, 2020
The Post-Stroke Checklist: longitudinal use in routine clinical practice during first year after stroke
Kristina Månsson1,2, Martin Söderholm3,4, Ida Berhin3,5
1Department of Neurology, Skåne University Hospital, Jan Waldenströms gata 15, Malmö, 205 02, Sweden. kkmansson@gmail.com.
Insights
The Post-Stroke Checklist (PSC) shows stroke-related health problems persist in two-thirds of patients at 1 year, highlighting the need for continuous follow-up. Secondary prevention requires intensified focus beyond the checklist.
Area of Science:
- Neurology
- Public Health
- Healthcare Management
Background:
- Limited research exists on the Post-Stroke Checklist (PSC) for longitudinal stroke follow-up in clinical settings.
- This study mapped stroke-related health problem prevalence and interventions using the PSC at 3 and 12 months post-stroke.
Purpose of the Study:
- To evaluate the utility of the Post-Stroke Checklist (PSC) for tracking stroke recovery and health issues over time.
- To assess the prevalence of stroke-related health problems and the effectiveness of interventions at 3 and 12 months post-stroke.
Main Methods:
- A comprehensive nurse-led follow-up using a 14-item PSC was conducted at 3 and 12 months post-stroke for patients discharged in 2018-2019.
- Time consumption, health problems, and interventions were recorded, with 12-month problems categorized as new, persistent, or resolved compared to 3-month data.
Main Results:
- Of 146 patients completing follow-up, 40% had new stroke-related health problems at 12 months, most commonly in secondary prevention and life after stroke domains.
- Stroke recurrence was 7.5%, 43% had hypertension, and smoking cessation was low. New interventions were provided to 53% at 12 months versus 84% at 3 months.
Conclusions:
- Despite a decrease beyond 3 months, two-thirds of patients experienced stroke-related health problems at 1 year, underscoring the value of continuous PSC-based follow-up.
- Current follow-up strategies are insufficient for achieving secondary prevention targets, necessitating a more intensive approach.
Background:
Few studies describe the use of the Post-Stroke Checklist (PSC) as a tool for longitudinal stroke follow-up in clinical practice. We mapped the prevalence of stroke-related health problems and targeted interventions at 3 and 12 months post-stroke by using the PSC.
Methods:
Patients with acute stroke discharged home in 2018-2019 at Skåne University Hospital, Sweden, were invited to participate in a comprehensive nurse-led follow-up based on a 14-item PSC 3 and 12 months post-stroke. We measured time consumption, screened for stroke-related health problems, compared the findings, and recorded targeted healthcare interventions. Problems at 12 months were grouped into new, persistent, or none compared to the 3-month evaluation.
Results:
Of 200 consecutively included patients, 146 (77%) completed both the 3- and 12-month follow-ups. At 12-month follow-up, 36% of patients reported no stroke-related health problems, 24% reported persistent problems, and 40% reported new problems since the 3-month evaluation. New problems at 12 months were most common within the domains: secondary prevention (23%) and life after stroke (10%). Stroke recurrence rate was 7.5%, 43% had high blood pressure, and few smokers had quit smoking. At 12 months, 53% received at least one new healthcare intervention, compared to 84% at 3 months.
Conclusions:
Stroke-related health problems decreased beyond 3 months but were still present in two-thirds of patients at 1 year. This emphasizes the relevance of continuous structured follow-up using the PCS. However, the follow-up alone was insufficient to adequately achieve treatment targets for secondary prevention, which require intensified focus.
Trial Registration:
ClinicalTrials.gov ID NCT04295226, (04/03/2020).
