(Stroke. 1997;28:916-921.)
© 1997 American Heart Association, Inc.
Articles |
Knowledge of Risk Among Patients at Increased Risk for Stroke
From the Center for Health Policy Research and Education, Duke University, Durham (G.P.S., L.B.G., D.B.M.); the Health Services Research Center, Department of Public Health Sciences, Bowman Gray School of Medicine, Winston-Salem (S.J.C.); the Divisions of General Medicine (G.P.S., D.B.M.) and Neurology (L.B.G.), Department of Medicine, and the Department of Community and Family Medicine (G.P.S.), Duke University Medical Center, Durham; Research Triangle Institute, Research Triangle Park (A.J.B.); Bowman Gray School of Medicine, Wake Forest University, Winston-Salem (C.E.); Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill (G.H.D.); the Center for Health Services Research in Primary Care (R.D.H.) and Division of Neurology (L.B.G.), Veterans Affairs Medical Center, Durham, NC; and the Center on Aging, University of Kansas Medical Center, Kansas City, and the Department of Health Services Administration, University of Kansas, Lawrence (P.W.D.).
Background and Purpose Patients who recognize their increased risk for stroke are more likely to engage in (and comply with) stroke prevention practices than those who do not. We describe perceived risk of stroke among a nationally diverse sample of patients at increased risk for stroke and determine whether patients' knowledge of their stroke risk varied according to patients' demographic and clinical characteristics.
Methods Respondents were recruited from the Academic Medical Center Consortium (n=621, five academic medical centers, inpatients of varying age); the Cardiovascular Health Study (n=321, population-based sample of persons aged 65+ years); and United HealthCare (n=319, five health plans, inpatients and outpatients typically younger than 65 years). The primary outcome was awareness of being at risk for stroke.
Results Only 41% of respondents were aware of their increased risk for stroke (including less than one half of patients with previous minor stroke). Approximately 74% of patients who recalled being told of their increased stroke risk by a physician acknowledged this risk in comparison with 28% of patients who did not recall being informed by a physician. Younger patients, depressed patients, those in poor current health, and those with a history of TIA were most likely to be aware of their stroke risk.
Conclusions Over one half of patients at increased risk of stroke are unaware of their risk. Healthcare providers play a crucial role in communicating information about risk, and successful communication encourages adoption of stroke prevention practices. Educational messages should be targeted toward patients least likely to be aware of their risk.
Key Words: health education • risk factors • stroke prevention
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