Post-stroke follow-up: Time to organize.


Journal

Revue neurologique
ISSN: 0035-3787
Titre abrégé: Rev Neurol (Paris)
Pays: France
ID NLM: 2984779R

Informations de publication

Date de publication:
Historique:
received: 22 06 2017
revised: 10 11 2017
accepted: 28 02 2018
pubmed: 9 10 2018
medline: 4 6 2019
entrez: 9 10 2018
Statut: ppublish

Résumé

General practitioners (GPs) are pivotal in the organization of the entire post-stroke management system. This study aimed to examine the sequelae of chronic post-stroke patients and to assess whether the medical follow-up organized by GPs is truly in accordance with current recommendations and patients' clinical needs. This was an observational study including chronic post-stroke patients after a first stroke. Their post-stroke follow-ups (visits to GPs and specialist doctors) were compared with guidelines and with clinical needs as evaluated through a number of questionnaires. Overall, 53.2% of patients visited a neurologist as recommended and, although 49.4% had neuropsychiatric consequences, only 6.3% visited a psychiatrist. Similarly, while 34.2% had significant post-stroke disability, only 6.3% saw a rehabilitation physician. Taking into account not only cardiovascular prevention, but all post-stroke consequences, medical follow-ups as organized by GPs were not in accordance with recommendations and failed to take advantage of the currently available multidisciplinary resources required to improve patients' needs.

Sections du résumé

BACKGROUND/OBJECTIVE OBJECTIVE
General practitioners (GPs) are pivotal in the organization of the entire post-stroke management system. This study aimed to examine the sequelae of chronic post-stroke patients and to assess whether the medical follow-up organized by GPs is truly in accordance with current recommendations and patients' clinical needs.
METHODS METHODS
This was an observational study including chronic post-stroke patients after a first stroke. Their post-stroke follow-ups (visits to GPs and specialist doctors) were compared with guidelines and with clinical needs as evaluated through a number of questionnaires.
RESULTS RESULTS
Overall, 53.2% of patients visited a neurologist as recommended and, although 49.4% had neuropsychiatric consequences, only 6.3% visited a psychiatrist. Similarly, while 34.2% had significant post-stroke disability, only 6.3% saw a rehabilitation physician.
CONCLUSION CONCLUSIONS
Taking into account not only cardiovascular prevention, but all post-stroke consequences, medical follow-ups as organized by GPs were not in accordance with recommendations and failed to take advantage of the currently available multidisciplinary resources required to improve patients' needs.

Identifiants

pubmed: 30293879
pii: S0035-3787(17)30652-5
doi: 10.1016/j.neurol.2018.02.087
pii:
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

59-64

Informations de copyright

Copyright © 2018. Published by Elsevier Masson SAS.

Auteurs

Etienne Santos (E)

EA4136 Handicap Activity Cognition Health, University of Bordeaux, Rue Léo-Saignat, 33000 Bordeaux, France.

Sophie Broussy (S)

Pôle de santéé publique, Bordeaux University, Bordeaux University Hospital, Place Amélie-Raba-Léon, 33000 Bordeaux, France; CCECQA, Observatoire Aquitain ObA2, Bordeaux University Hospital, Place Amélie-Raba-Léon, 33000 Bordeaux, France.

Emilie Lesaine (E)

Pôle de santéé publique, Bordeaux University, Bordeaux University Hospital, Place Amélie-Raba-Léon, 33000 Bordeaux, France; CCECQA, Observatoire Aquitain ObA2, Bordeaux University Hospital, Place Amélie-Raba-Léon, 33000 Bordeaux, France.

Florence Saillour (F)

Pôle de santéé publique, Bordeaux University, Bordeaux University Hospital, Place Amélie-Raba-Léon, 33000 Bordeaux, France; CCECQA, Observatoire Aquitain ObA2, Bordeaux University Hospital, Place Amélie-Raba-Léon, 33000 Bordeaux, France.

François Rouanet (F)

CCECQA, Observatoire Aquitain ObA2, Bordeaux University Hospital, Place Amélie-Raba-Léon, 33000 Bordeaux, France; INCIA CNRS UMR 5287, Neurology, Stroke Unit, University of Bordeaux, Bordeaux University Hospital, Place Amélie-Raba-Léon, 33000 Bordeaux, France.

Patrick Dehail (P)

EA4136 Handicap Activity Cognition Health, University of Bordeaux, Rue Léo-Saignat, 33000 Bordeaux, France; Department of Physical Medicine and Rehabilitation, Bordeaux University Hospital, Place Amélie-Raba-Léon, 33000 Bordeaux, France.

Pierre-Alain Joseph (PA)

EA4136 Handicap Activity Cognition Health, University of Bordeaux, Rue Léo-Saignat, 33000 Bordeaux, France; Department of Physical Medicine and Rehabilitation, Bordeaux University Hospital, Place Amélie-Raba-Léon, 33000 Bordeaux, France.

Florence Aly (F)

Department of Physical Medicine and Rehabilitation, Bordeaux University Hospital, Place Amélie-Raba-Léon, 33000 Bordeaux, France.

Igor Sibon (I)

INCIA CNRS UMR 5287, Neurology, Stroke Unit, University of Bordeaux, Bordeaux University Hospital, Place Amélie-Raba-Léon, 33000 Bordeaux, France.

Bertrand Glize (B)

EA4136 Handicap Activity Cognition Health, University of Bordeaux, Rue Léo-Saignat, 33000 Bordeaux, France; Department of Physical Medicine and Rehabilitation, Bordeaux University Hospital, Place Amélie-Raba-Léon, 33000 Bordeaux, France. Electronic address: bertrand.glize@chu-bordeaux.fr.

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