The new scientific statement, “Primary Care for Adult Patients after Stroke,” recognizes the importance of primary care in the care system for stroke patients, summarizing the available literature and providing a roadmap for care. holistic, goal-oriented and patient-centered. .
The statement is published today in Stroke, a journal of the American Stroke Association, a division of the American Heart Association.
Primary care professionals provide comprehensive and consistent essential care to patients after stroke. Most people will seek advice from their primary care team to reduce their high risk of recurrent stroke, prevent complications, and optimize their overall well-being. It emphasizes the need for comprehensive management after stroke that includes the commitment of caregivers and family members to support the patient.
Stroke is a complex disease with multiple causes, consequences and treatments. According to the release, approximately 800,000 American adults will have a new stroke each year and 10% will die within 30 days. At the time of their stroke, about 5% of patients under 55 and 40% over 85 have a moderate disability. 90 days after a stroke, a new stroke-related disability of at least moderate severity develops in 10% of young adults to 30% of adults over 65. In the United States, approximately 7 million adults are living with a stroke.
The first primary care appointment after a stroke should be held soon after discharge from the acute care or rehabilitation hospital, usually within 1 to 3 weeks. The current average time to first medical visit for patients discharged home after stroke is 27 days. An earlier post-stroke visit can reduce hospital readmissions and fill unintentional gaps in care that can exacerbate the high risk of stroke recurrence that marks the first three months after hospital discharge.
Screening at the first appointment and all subsequent appointments should include assessment of new or chronic risks of recurrent stroke such as high blood pressure, high cholesterol, diabetes, atrial fibrillation and blockage carotid or other arteries.
Additional screening is also important for complications such as anxiety or depression, cognitive impairment, bone fractures and the risk of falls, osteoporosis, bedsores and post-stroke seizures.
Specialist referrals should be recommended for any of these complications, if applicable.
In this statement, we affirm in a new way the role of the frontline professional in the care of people who have suffered a stroke. The essential functions of primary care as a specialty include: 1) diagnosis and management of acute symptoms, 2) management of chronic disease, and 3) disease prevention. Primary care professionals can provide consistent and comprehensive care for all patient needs, including coordinating any additional care or services patients may require from community service providers or subspecialty health care providers. “
Walter N. Kernan, MD, chairman of the statement writing group and professor of medicine at Yale University School of Medicine, in New Haven, Conn
American Heart Association
Kernan, WN, et al. (2021) Primary care of adult patients after stroke: a scientific statement from the American Heart Association / American Stroke Association. Stroke. doi.org/10.1161/STR.000000000000382.