A new pilot study conducted by Wake Forest Baptist Medical Center, Winston-Salem, NC, suggests that following hospital discharge, phone calls and conversations with a “stroke coach” may assist in keeping stroke patients on track during recovery. “Many patients are not only overwhelmed with the new diagnosis of stroke, but also the risk factors that might be uncovered during the stroke hospital stay. This means new medications or adjustments to the old ones,” explains Cheryl D. Bushnell, MD, associate professor of neurology and director of Wake Forest Baptist’s Primary Stroke Center. Bushnell adds that additional stroke education provided once the patient returns to the home setting may assist in easing the transition.
According to a recent news release, the study encompassed 30 stroke patients who had a change of at least two medications between admission and discharge. Researchers note that the first 20 patients were selected for “coach” calls while the remainder of the patients served as a control group, without coaching. The release notes that prior to the patients’ discharge, the coach reviewed a packet of information with each patient and their caregiver. The information educated patients about when to call 911 or their physician and/or pharmacist, lifestyle suggestions to prevent stroke, and a checklist of the individual patient’s risk factors with additional information about each. A list of their current medications was also included, detailing what the medications were intended to treat and the dosage.
The study reports that 2 weeks following discharge, each of the 20 study participants in the coaching group received a call from the medication coach who offered general information about stroke, emphasized the importance of preventing future strokes, explained how to mitigate individual stroke risk factors, and the importance of taking their prescribed medications. Researchers add that the medication coach also assessed each patient’s understanding of their discharge orders by reviewing stroke medications on the discharge lists one by one and testing patients on whether they were still required to take a medication, and if not, why they were no longer taking it, the purpose behind each medication prescribed, how it should be taken, refilled, and how its side effects could be identified.
The patients were then contacted after 3 months. The researchers note that while there was no observed difference between the groups in regard to knowledge of medications and stroke, 93.8% of patients in the coaching group knew how to react in the event that problems or symptoms worsened, compared to 77.8% of the control group. The results also suggest that 93.8% of coaching participants had been seen by their primary provider since discharge, compared to 60% of the those in the control group.
Wake Forest Baptist researchers acknowledge the small study’s limitations, but also highlight its positive feedback stemming from participants and their experience with post-discharge coaching and the feasibility of integrating it into discharge plans.
Source: Wake Forest Baptist Medical Center