Assessing Adherence to Posttraumatic Stress Disorder Screening in Young Stroke Survivors

Background: Over 795 000 US people per year experience a stroke, and 10% are younger than 50 years. After a stroke, posttraumatic stress disorder (PTSD) affects 10% to 30% of those patients and may compromise a survivor's secondary prevention compliance. At an inner-city clinic in Maryland where up to 300 young adult stroke survivors are followed, zero patients were screened for PTSD. A quality improvement project was implemented to screen for PTSD in a young adult stroke survivor clinic and to provide them with psychotherapy referrals and follow-up. Methods: Over 15 weeks in the fall of 2023, all patients presenting to the young adult stroke survivor clinic were screened for PTSD using the Posttraumatic Stress Disorder Checklist-5 validated screening tool. Providers and medical staff were all educated on the tool before implementation. Results: During the 15-week implementation period, 72 patients presented to the clinic. Posttraumatic stress disorder screening was completed for 88.9% (64/72). Of those, 32.8% (21/64) completed the Posttraumatic Stress Disorder Checklist-5 via the electronic health record, and 67.2% (43/64) completed it by in-person screening. Of the 64 patients screened, 12 patients screened positive for PTSD (18.8%, 12/64). Among those screening positive, 75% (9/12) were given a referral for psychotherapy. Conclusions: Literature reports that PTSD compromises stroke survivors' ability to optimize their health after a stroke. Screening identifies those experiencing symptoms of PTSD, providing an opportunity for referral and treatment. Results show that routine care of young stroke survivors can effectively include screening for PTSD.