Ask for Help When Recovering From a Stroke

Following a stroke, it isn't uncommon for patients to be overwhelmed by a loss of function or the need for new medications. Those that skip drug doses or take the wrong medication are more likely to be rehospitalized.

A small pilot study has found that the answer may be offering patients a "stroke coach" after discharge from the hospital.

Conversations and phone calls from a stroke coach appear to better keep stroke survivors on a path toward recovery.

Discuss post-stroke symptoms with a specialist.

Cheryl D. Bushnell, MD, associate professor of neurology and director of Wake Forest Baptist's Primary Stroke Center, noted that patients are not only overwhelmed with the diagnosis of a stroke, but also risk factors often uncovered during a hospital stay.

"This means new medications or adjustments to the old ones," said Dr. Bushnell. "Most important, all of the stroke education we give to people in the hospital before going home may be forgotten with everything else that happens during the hospital stay, so getting some additional teaching after getting home could help this transition."

During the study, researchers followed 30 stroke patients who received lifestyle suggestions and individualized lists of risk factors prior to leaving the hospital. All of the patients were asked to change at least two medications between hospital admission and discharge. Of the participants, 20 were selected to receive calls from a stroke coach.

Two weeks after discharge, the patients assigned a stroke coach received a call with general information about stroke and the importance of preventing a recurrence, along with tips for lowering their risk.

The coaches also stressed the importance of taking prescribed medication, and provided information about how each drug works, side effects and how to take them. Participants could ask questions about medication or stroke recovery at the end of the call.

Following calls, the coach asked pharmacists to follow up regarding medication questions and had stroke nurses provide answers regarding stroke or recovery. The coach followed up on the advice with a letter written at the seventh grade level to ensure they understood the advice.

Primary care doctors of the patients also received a report regarding the conversations.

After three months, investigators interviewed patients. Both groups were found to have similar knowledge regarding stroke and medications.

However, they found that 94 percent of the coached group knew what to do if problems or symptoms worsened compared to 78 percent who did not receive coaching. Of the patients with a coach, 94 percent had followed up with their primary care doctor versus only 60 percent in the other group.

Overall, stroke survivors that received coaching also were less likely to be depressed, reported better health status and tended to report less disability.

Because the study was small it will require confirmation with larger studies, though researchers indicated the findings suggest positive outcomes for patients.

The study was recently published in journal BMC Public Health.