Primary Care of Adult Patients After Stroke: A Scientific Statement From the American Heart Association/American Stroke Association

被引:58
作者
Kernan, Walter N. [1 ]
Viera, Anthony J. [2 ]
Billinger, Sandra A. [3 ]
Bravata, Dawn M. [4 ]
Stark, Susan L. [7 ]
Kasner, Scott E. [5 ]
Kuritzky, Louis [6 ]
Towfighi, Amytis [8 ]
机构
[1] Yale Sch Med, New Haven, CT 06510 USA
[2] Duke Univ, Durham, NC 27706 USA
[3] Univ Kansas, Med Ctr, Lawrence, KS 66045 USA
[4] Richard L Roudebush VA Med Ctr, Indianapolis, IN USA
[5] Univ Penn, Philadelphia, PA 19104 USA
[6] Univ Florida, Gainesville, FL 32611 USA
[7] Washington Univ St Louis, St Louis, MO USA
[8] Univ Southern Calif, Los Angeles, CA 90007 USA
基金
美国国家卫生研究院;
关键词
AHA Scientific Statements; aftercare; family practice; internal medicine; primary health care; secondary prevention; stroke; stroke rehabilitation; TRANSIENT ISCHEMIC ATTACK; BLOOD-PRESSURE; MEDICATION ADHERENCE; CANADIAN-STROKE; SECONDARY PREVENTION; SOCIOECONOMIC-STATUS; PRACTICE GUIDELINES; SELF-MANAGEMENT; TEMPORAL TRENDS; HIGH-RISK;
D O I
10.1161/STR.0000000000000382
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Primary care teams provide the majority of poststroke care. When optimally configured, these teams provide patient-centered care to prevent recurrent stroke, maximize function, prevent late complications, and optimize quality of life. Patient-centered primary care after stroke begins with establishing the foundation for poststroke management while engaging caregivers and family members in support of the patient. Screening for complications (eg, depression, cognitive impairment, and fall risk) and unmet needs is both a short-term and long-term component of poststroke care. Patients with ongoing functional impairments may benefit from referral to appropriate services. Ongoing care consists of managing risk factors such as high blood pressure, atrial fibrillation, diabetes, carotid stenosis, and dyslipidemia. Recommendations to reduce risk of recurrent stroke also include lifestyle modifications such as healthy diet and exercise. At the system level, primary care practices can use quality improvement strategies and available resources to enhance the delivery of evidence-based care and optimize outcomes.
引用
收藏
页码:E558 / E571
页数:14
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