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MORe PREcISE: Longitudinal patient reported outcome measures in stroke at 3 and 6 months.
,
Marie AG Verstraete,
Ben Carter,
Alexander Smith ,
Anna Pennington,
Jonathan Hewitt
Journal of Stroke and Cerebrovascular Diseases, Volume: 33, Issue: 12, Start page: 108023
Swansea University Author:
Alexander Smith
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DOI (Published version): 10.1016/j.jstrokecerebrovasdis.2024.108023
Abstract
Background and PurposePost-stroke morbidity is common, but little is known about the burden on patients’ lives from their own perspective. Understanding morbidity from the point of view of the patient may support targeted intervention in post-stroke recovery. This study used a stroke specific Patien...
| Published in: | Journal of Stroke and Cerebrovascular Diseases |
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| ISSN: | 1052-3057 |
| Published: |
Elsevier BV
2024
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| Online Access: |
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa67848 |
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| Abstract: |
Background and PurposePost-stroke morbidity is common, but little is known about the burden on patients’ lives from their own perspective. Understanding morbidity from the point of view of the patient may support targeted intervention in post-stroke recovery. This study used a stroke specific Patient Reported Outcome Measure (PROM) containing Mental health (MH) and Physical Health (PH) domains and 5 stroke specific questions. We aimed to consider trends over a 6-month period and further assess the association between the MH and PH measures and common clinical measures.MethodsA multicenter prospective cohort study was conducted at 19 hospital sites across England and Wales. Patients were enrolled from August 2018 to September 2019. Clinical measures and PROMs were assessed at three timepoints: acutely following the index stroke, at 3 and 6-months post-stroke. Clinical measures and PROMs were assessed in each of these points.ResultsPhysical health PROM domains show significant gradual improvement across the study period (χ2 42.6312, p<0.0001), whereas cognitive function domains (χ2 3.7849, p<0.875) did not echo this trend. All clinical measures (GAD-7, PHQ9, MoCA, MRS) were associated with poorer PROM MH outcomes, (aMD -4.4, CI -0.59, -0.29, p≤0.001, aMD -0.45, CI -0.59, -0.32, p=<0.001, aMD 0.75, CI 0.56, 0.95, aMD -1.91, CI -2.41, -1.47, p≤0.001). Clinical measures of disability, as per the MRS, are associated with poor PROM PH scores (aMD -0.57, 95% CI -0.94, -0.20, p=0.003).ConclusionsThis research indicates there is unmet cognitive burden in stroke survivors. PROMs may be able to measure unmet more discretely than common clinical tools that are used post-stroke. Further research and guidance on how to integrate PROMs into current clinical frameworks is essential. |
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| Keywords: |
Morbidity; Patient Reported Outcome; PROM; Stroke |
| College: |
Faculty of Medicine, Health and Life Sciences |
| Funders: |
This research was funded by the Stroke Research and Innovation Fund (SRIF) of the Stroke Implementation Group (SIG) [Welsh Government] – 03 ABUHB. AS is funded by the Stroke Association (SA PGF 18\100029 Stroke Association Post-Graduate Fellowship). This study represents the independent research part funded by the NIHR Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London (BC). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. |
| Issue: |
12 |
| Start Page: |
108023 |