Stroke survivors should see their primary care physician sooner

 

Stroke survivors should see their primary care physician sooner than they generally are, according to a recent scientific statement(link opens in new window) from the American Heart Association. The shortened interval between discharge to home and first medical visit could reduce stroke recurrence and hospital readmissions.

The new guidance recommends an initial doctor's visit between 1-3 weeks after a stroke survivor is discharged from an acute care or rehabilitation hospital. The current average interval to first medical visit is currently 27 days.

The statement emphasizes the role of primary care for patients with stroke, summarizes the latest science and provides a roadmap for care. Sooner is better – and the primary care physician is on the front line to improve post-stroke outcomes.

The initial and subsequent appointments should include screenings for high blood pressure, high cholesterol, diabetes, atrial fibrillation, and blockage in the carotid or other arteries. The PCP should also look out for complications such as anxiety or depression, cognitive problems, bone fracture and fall risk, osteoporosis, pressure ulcers and seizures.

The primary care physician should also address the importance of medication compliance and adjustment of medication as needed.

Lifestyle factors, including healthy diet and physical activity, are important for preventing a second stroke. Low-salt and Mediterranean diets are recommended for stroke risk reduction. Stroke survivors are especially at risk for sedentary and prolonged sitting behaviors, and they should be encouraged to perform physical activity in a supervised and safe manner.

Changing patient behaviors such as diet, exercise, and medication compliance requires more than just simple advice or a brochure from their physician. Programs that use theoretical models of behavior change, proven techniques and multidisciplinary support are needed.

The statement describes stroke as a complex disease that requires early and resolute monitoring and treatment, noting that about 800,000 adults in the U.S. will have a new or recurrent stroke each year, and 10% will die within 30 days. Compared with white people, Black people have a higher risk of a recurrent stroke within one year.