Steps against recurrent stroke plus: patient transition program.

Stroke is a devastating health event that affects 800,000 people annually in the United States. Nearly 20% of strokes are recurrent strokes. Research shows that support after discharge from the hospital poststroke is frequently inadequate. The purpose of "Steps Against Recurrent Stroke (STARS) Plus: Patient Transition Program" was to design and deliver a program to facilitate optimal recovery for stroke survivors and prevent recurrent stroke. The program began at discharge from the hospital and continued through the first year of rehabilitation and recovery. Twelve hospitals participated; 261 patients enrolled, and contact was established with 193. Outcomes were gathered based on patient self-report of health status using the Short-Form Health Survey at 30, 90, 180, and 360 days. A dependent sample t test was completed comparing participants' 30- and 360-day follow-up scores. Results demonstrated an overall increase in subjective pain. A repeated multivariate analysis of variance was conducted to compare 30- and 360-day Short-Form Health Survey scores across age and subscales. Results revealed that those in the younger and older age groups reported poorer health outcomes. Findings demonstrate a reduction in rehospitalization after stroke, increased medication adherence, strong patient satisfaction, and significant differences in health-related outcome measures across age groups, suggesting that middle-aged stroke survivors experience better health outcomes than younger or older age groups. Future programs should consider targeting pain management in all ages and education targeted at younger and older age groups, because they reported poorer health outcomes. The findings from this program should contribute to the guidance and insight for others developing transitional interventions for stroke survivors.

An evaluation of stroke education in AVAIL registry hospitals.

The purpose of this study is to explore factors associated with recall of medication education and satisfaction with healthcare provider communication in patients with acute stroke or transient ischemic attack. This is an analysis of data from the AVAIL (Adherence Evaluation of Acute Ischemic Stroke Longitudinal) study. At 3 months after discharge, 2,219 stroke patients from 99 sites were interviewed and asked about their perceptions of education and communication with their healthcare providers as well as their current medication use and knowledge. Results show that less than 2% of the respondents reported not understanding how to take their medications, 4% did not know how to refill their medications, and 5% did not know the reason they were taking them. A vast majority (92%) of participants reported high levels of satisfaction in their communications with healthcare providers after discharge. Although overall understanding and satisfaction was high, older subjects were less likely to recall receiving medication information at discharge or to understand their medications. Similarly, African Americans and patients discharged from an academic hospital were less likely to report receiving a written medication list. This report highlights the success of education efforts and potential areas for additional improvement.