If your doctor and hospital did nothing to stop the neuronal cascade of death in the first week, then your primary care doctor has a massive amount of work to do to get you recovered. Unless their definition of optimal recovery uses the tyranny of low expectations to justify just surviving a stroke as enough. Ask your doctor what their goal is for your recovery, that will tell you if you need a new doctor, 100% recovery is the only goal in stroke. If your stroke medical professionals don't have that as a goal you need to fire the lot.
Comprehensive primary care is vital to holistic care and optimal recovery after a stroke
Embargoed until 4 a.m. CT/5 a.m. ET Thursday, July 15, 2021
DALLAS, July 15, 2021 — Statement Highlights:
- The new scientific statement, “Primary Care of Adult Patients After Stroke,” acknowledges the importance of primary care in the system of care for patients with stroke, summarizing the available literature and providing a roadmap for holistic, goal-directed and patient-centered care.
- The statement is published today in Stroke, a journal of the American Stroke Association, a division of the American Heart Association.
- Primary care professionals provide essential comprehensive and consistent care to patients after a stroke. Most people will seek guidance from their primary care team to reduce their high risk for recurrent stroke, prevent complications and optimize overall well-being. It outlines the need for comprehensive post-stroke management that includes engaging caregivers and family members to support the patient.
- Stroke is a complex disease with many causes, consequences and treatments. According to the statement, approximately 800,000 U.S. adults will have a new stroke each year, and 10% will die within 30 days. At the time of their stroke, approximately 5% of patients younger than 55 years of age and 40% over 85 years have moderate disability. By 90 days after a stroke, new stroke-related disability of at least moderate severity develops in 10% of younger adults to 30% of adults over age 65 years. There are about 7 million adults in the U.S. living with stroke.
- The first primary care appointment after a stroke should occur soon after discharge from the acute care or rehabilitation hospital, generally within 1-3 weeks. The current average interval to first medical visit for patients discharged home after stroke is 27 days. An earlier post-stroke visit may reduce hospital readmission and address inadvertent gaps in care that may exacerbate the high risk for stroke recurrence that marks the first three months after hospital discharge.
- Screening at the first and all subsequent appointments should include assessing new or chronic risks for recurrent stroke such as high blood pressure, high cholesterol, diabetes, atrial fibrillation and blockage in the carotid or other arteries.
- Additional screening is also important for complications including anxiety or depression, cognitive impairment, bone fracture and fall risk, osteoporosis, pressure ulcers and post-stroke seizures.
- Specialist referrals should be recommended for any of these complications as appropriate.
“In this statement, we affirm in a new way the role of the primary care professional in caring for people with stroke. The core functions of primary care as a specialty include: 1) diagnosis and management of acute symptoms, 2) chronic disease management and 3) disease prevention,” said Walter N. Kernan, M.D., chair of the statement writing group and a professor of medicine at Yale University School of Medicine, in New Haven, Conn. “Primary care professionals can ensure consistent and comprehensive care for the full needs of patients, including coordinating any additional care or services patients may need from community services providers or from subspecialty health care providers.”
Additional Resources:
- Multimedia is available on the right column of the media alert link https://newsroom.heart.org/news/comprehensive-primary-care-is-vital-to-holistic-care-and-optimal-recovery-after-a-stroke?preview=dbc19d0d0bf8b7b4c7ddde45d7ccfd7b
- After July 15, view the manuscript online.
- After July 15, view the online commentary by Deborah A. Levine M.D., M.P.H., associate professor of medicine at the University of Michigan in Ann Arbor – “How to Optimize the Primary Care of Individuals with Stroke”
- Find out more about stroke.
- Life after Stroke
- Find help and support after a stroke
- 2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack
- 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association
- AHA/ASA Guidelines for Adult Stroke Rehabilitation and Recovery
- Guideline for the Primary Prevention of Stroke
- Guideline for the Prevention of Stroke in Women
- Follow AHA/ASA news on Twitter @HeartNews
- Follow news from Stroke, the ASA/AHA journal @StrokeAHA_ASA
The Association receives funding primarily from individuals. Foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers and the Association’s overall financial information are available here.
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