New Model For Stroke Aftercare Is A Success Says BJGP Study

Main Category: Stroke
Also Included In: Rehabilitation / Physical Therapy;  Primary Care / General Practice
Article Date: 24 Sep 2006 - 19:00 PDT

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A model which highlights the physical and emotional needs of stroke victims and their carers has been specifically devised for use in primary care.

Published in the October issue of the British Journal of General Practice (BJGP) the model draws on the experience of a group of doctors in Bradford who have been researching the needs of stroke patients and their carers for several years. The first pilot study showed that the model helped health and social care professionals to systematically identify patient and carer problems and that three months after the assessment 75% of these problems had been resolved.

Main problem areas identified by patients were mobility/falls and personal hygiene. Carers reported problems with mood and social life issues and patient handling. The model was tested by 47 patients and 21 carers over a three month period, identified from a hospital-based stroke register. The average age of patients was 72 years and they were, on average, seven-eight months post stroke.

Lead researcher, Ms Jenni Murray, from the Academic Unit of Elderly Care and Rehabilitation, St Luke's Hospital, Bradford, said: "The longer-term needs of patients who have had a stroke and their carers are not being met by existing services. Traditionally, stroke treatments have given emphasis only to the physical wellbeing of the patient. This new model for stroke aftercare has been based on the expressed needs of patients and carers and we are keen to hear the views of community-based health and social care professionals, patients and carers on the model and the pilot study.

In the paper, Jenni also added that more work needs to be done. 'Having demonstrated the feasibility of this novel system of stroke care, the intervention now requires a robust evaluation before it can be recommended for routine clinical use.'

Dr Maureen Baker, RCGP Honorary Secretary and spokesperson on stroke, said: "This study highlights the importance of well thought-through aftercare for stroke victims and their carers. A co-ordinated approach by health and social care professionals is what we are always working towards. The population isn't getting any younger and we need to get excellent models like this one into place now to avoid even more strain on the NHS in years to come. I look forward to seeing the results of an evaluation of this model."

Laura Funnell, Deputy Director of Communications at The Stroke Association commented: "This study which was funded by The Stroke Association is a positive step forward in the rehabilitation process. After stroke care should encourage all aspects of recovery taking into account emotional as well as physical well-being. Acknowledging the needs of stroke survivors is paramount to this, and could improve the lives of the estimated 150,000 people that have a stroke in the UK each year."

Health professionals taking part in the study reported satisfaction with the model in that it 'encouraged them to work in a manner more consistent with the expressed needs of patients and carers who were adjusting to the longer-term impact of stroke'. Patients and carers felt the process would be even more valuable if instigated sooner after hospital discharge.

The study also discussed the importance of the longer-term management of stroke in primary care: enhancing continuity of care; improving access to community services; offering a coordinated approach; and the necessity of regular reviews. The study also pointed out the diverse training needs required by staff providing post-acute stroke care.

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Source: October edition of the British Journal of General Practice (BJGP)

1. Murray J, Young J, Forster A, et al. Feasibility study of a primary care-based model for stroke aftercare. Br J Gen Pract 2006; 56: 775-780

2. Eight nurses, two therapists and five social workers were recruited and trained to complete care plans of patient and carer needs using 40 questions looking at their needs. Questions were based on 16 problem-specific areas: transfer of care; communication; medicines and general health; pain; mobility and fails; driving and general transport; incontinence; sexual relations; shopping and meal preparation; house and home; finances and benefits; personal hygiene; memory; mood changes; social needs and carer emotional/social needs.

3. A community nurse was funded to co-ordinate the responses and met monthly with the research team of two stroke physicians, two physiotherapists and two occupational therapists, to resolve any issues.

4. The BJGP is published monthly and distributed to over 25,000 RCGP members, associates, and subscribers in more than 40 countries worldwide. Its primary purpose is to publish first-rate, peer reviewed research papers on topics relevant to primary care.

5. The Royal College of General Practitioners is the largest membership organisation in the United Kingdom solely for GPs. It aims to encourage and maintain the highest standards of general medical practice and to act as the "voice" of GPs on issues concerned with education, training, research and clinical standards. Founded in 1952, the RCGP has over 25,000 members who are committed to improving patient care, developing their own skills and promoting general practice as a discipline. http://www.rcgp.org.uk

For further information please go to:
Royal College of General Practitioners

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