Adapting Tools to Implement Stroke Risk Management to Veterans
| Status: | Completed |
|---|---|
| Conditions: | Peripheral Vascular Disease, Neurology |
| Therapuetic Areas: | Cardiology / Vascular Diseases, Neurology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 10/13/2018 |
| Start Date: | January 2009 |
| End Date: | December 2013 |
The purpose of this study is to develop and evaluate the local adaptation of existing stroke
prevention tools into practice. A stroke prevention program is a collection of materials
including written materials like pamphlets and brochures, videotapes and training guides for
stroke survivors and evidence based guidelines for the doctors that provide care for them.
Other tools that may be used in a stroke prevention program include devices that help
patients monitor medical symptoms at home like home blood pressure machines or blood sugar
monitors and messaging devices that allow reporting symptoms from home to a health care
provider.
We hypothesized Veterans with stroke who receive the Veteran Stroke Prevention Program would
engage in better medication compliance and stroke specific quality of life compared to those
who did not receive the program.
prevention tools into practice. A stroke prevention program is a collection of materials
including written materials like pamphlets and brochures, videotapes and training guides for
stroke survivors and evidence based guidelines for the doctors that provide care for them.
Other tools that may be used in a stroke prevention program include devices that help
patients monitor medical symptoms at home like home blood pressure machines or blood sugar
monitors and messaging devices that allow reporting symptoms from home to a health care
provider.
We hypothesized Veterans with stroke who receive the Veteran Stroke Prevention Program would
engage in better medication compliance and stroke specific quality of life compared to those
who did not receive the program.
Stroke affects at least 15,000 veterans each year, and this number will likely increase as
the veteran population ages. According to the American Heart Association, the prevalence of
stroke is expected to double by 2020 with the increased proportion of older adults
nationwide. Our preliminary Quality Enhancement Research Initiative work indicates that
stroke risk factors are often undermanaged in the Veterans Health Administration.
This proposed study of a stroke risk factor management program may benefit the Veteran Health
System in several ways. First, it offers a systematic program for reduction in stroke risk
factors leading to better health for our veterans and a reduction in inpatient and outpatient
rehabilitation and home health services for these events. Second, the Veteran Stroke
Prevention Program takes into account the varied resources and services offered in VAMCs
across the nation, allowing the program to be tailored both to a given facility and to the
individual veteran's needs and readiness to change. Importantly, the program could allow all
VA facilities to offer guideline-concurrent stroke risk reduction programs and therefore
increase compliance with VA/Department of Defense, American Heart Association, and the Joint
Commission stroke care guidelines and improve their quality of stroke care.
Comparison(s): We will compare two regionally matched facilities on rates of secondary stroke
prevention guideline care during the course of the study at the intervention sites.
the veteran population ages. According to the American Heart Association, the prevalence of
stroke is expected to double by 2020 with the increased proportion of older adults
nationwide. Our preliminary Quality Enhancement Research Initiative work indicates that
stroke risk factors are often undermanaged in the Veterans Health Administration.
This proposed study of a stroke risk factor management program may benefit the Veteran Health
System in several ways. First, it offers a systematic program for reduction in stroke risk
factors leading to better health for our veterans and a reduction in inpatient and outpatient
rehabilitation and home health services for these events. Second, the Veteran Stroke
Prevention Program takes into account the varied resources and services offered in VAMCs
across the nation, allowing the program to be tailored both to a given facility and to the
individual veteran's needs and readiness to change. Importantly, the program could allow all
VA facilities to offer guideline-concurrent stroke risk reduction programs and therefore
increase compliance with VA/Department of Defense, American Heart Association, and the Joint
Commission stroke care guidelines and improve their quality of stroke care.
Comparison(s): We will compare two regionally matched facilities on rates of secondary stroke
prevention guideline care during the course of the study at the intervention sites.
Inclusion Criteria:
- Veterans 18 years or older hospitalized with stroke or Transient Ischemic Attack at
Indianapolis Veterans Administration Medical Center and Houston Veteran Administration
Medical Center;
- willing to participate;
- access to telephone;
- speaks and understands English;
- no severe cognitive impairments;
- life expectancy of at least 6 mos;
- willingness to follow-up in Veterans Administration outpatient care.
Exclusion Criteria:
- Severe aphasia or cognitive impairment;
- active alcohol or substance abuse;
- cannot or unwilling to participate;
- does not speak or understand English;
- life expectancy less than 6 mos;
- no access to telephone;
- no Veterans Administration outpatient follow-up.
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