Abstract WP366: Secondary Stroke Prevention Program: Effect on Stroke Specific Quality of Life
We conducted an evaluation of the implementation of a Veteran Secondary Stroke Prevention Program at two VA medical center sites. We prospectively recruited patients hospitalized for stroke/TIA and randomized to either an intervention or a control group. Each site locally tailored the intervention. The program targeted stroke self-management and risk factors or a placebo telephone call program that mimicked the intervention schedule. The self-management program followed a standardized manual (control call simply asked how the patient was doing), and interviews were conducted at baseline during hospital visit, 3 and 6 months. To address veteran preferences, both sites implemented the ASA Sharegiver peer support program to subjects in the intervention.We assessed stroke health-related quality of life with the SS-QOL and depression with the PHQ9.
Results: The final sample included 174 veteran patients with an acute stroke/TIA and were randomized to receive either a VSPP (n=87) or a control program (n=87) stratified by stroke/TIA and by receipt of inpatient rehabilitation to control for stroke severity. A random subject effect was used to correlate observations from the same subject. Subgroup analyses were run with subgroups defined as diagnosed TIA or Stroke at acute event. On the SSQoL overall score and the Language subscale, those with a TIA in the intervention group reported an improved score while those in the control group reported a declined score at 3 mos. For those with Stroke in the intervention group, improvements in the Energy subscale were reported compared to declines in the control group at 3 months. For those with TIA in the intervention reported less depression than those in the control group and this effect was maintained at 6 months. Self-efficacy increased among those with stroke in the intervention group while decreased among the control group; although not significant.
Our results indicate the feasibility of delivering a local, secondary stroke prevention program. We report better stroke specific quality of life at 3 months among stroke/TIA survivors and less depression among those with TIA 6 months after the intervention suggesting that a post stroke program may enhance recovery.
Funded by Veterans Health Administration HSRD IAB 05-297-2
- © 2012 by American Heart Association, Inc.