MORe PREcISE: Longitudinal patient reported outcome measures in stroke at 3 and 6 months.

Corrigan, Amber E; Verstraete, Marie AG; Carter, Ben; Smith, Alexander; Pennington, Anna; Hewitt, Jonathan

doi:10.1016/j.jstrokecerebrovasdis.2024.108023

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MORe PREcISE: Longitudinal patient reported outcome measures in stroke at 3 and 6 months.

Amber E Corrigan

, 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...

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Published in:	Journal of Stroke and Cerebrovascular Diseases
ISSN:	1052-3057
Published:	Elsevier BV 2024
Online Access:	Check full text
URI:	https://cronfa.swan.ac.uk/Record/cronfa67848
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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.</abstract><type>Journal Article</type><journal>Journal of Stroke and Cerebrovascular Diseases</journal><volume>33</volume><journalNumber>12</journalNumber><paginationStart>108023</paginationStart><paginationEnd/><publisher>Elsevier BV</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>1052-3057</issnPrint><issnElectronic/><keywords>Morbidity; Patient Reported Outcome; PROM; Stroke</keywords><publishedDay>1</publishedDay><publishedMonth>12</publishedMonth><publishedYear>2024</publishedYear><publishedDate>2024-12-01</publishedDate><doi>10.1016/j.jstrokecerebrovasdis.2024.108023</doi><url/><notes/><college>COLLEGE NANME</college><department>Health and Social Care School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HSOC</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><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.</funders><projectreference/><lastEdited>2024-10-10T14:07:02.0974393</lastEdited><Created>2024-09-27T16:32:22.0001454</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">School of Health and Social Care - Therapies</level></path><authors><author><firstname>Amber E</firstname><surname>Corrigan</surname><orcid>0000-0003-0636-0114</orcid><order>1</order></author><author><firstname>Marie AG</firstname><surname>Verstraete</surname><order>2</order></author><author><firstname>Ben</firstname><surname>Carter</surname><order>3</order></author><author><firstname>Alexander</firstname><surname>Smith</surname><orcid>0000-0001-9656-6751</orcid><order>4</order></author><author><firstname>Anna</firstname><surname>Pennington</surname><order>5</order></author><author><firstname>Jonathan</firstname><surname>Hewitt</surname><order>6</order></author></authors><documents><document><filename>67848__32585__dc91e466a5d64bc08f66baaac968869f.pdf</filename><originalFilename>67848.VoR.pdf</originalFilename><uploaded>2024-10-10T14:05:30.3736747</uploaded><type>Output</type><contentLength>745184</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>Crown Copyright © 2024. 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spelling	v2 67848 2024-09-27 MORe PREcISE: Longitudinal patient reported outcome measures in stroke at 3 and 6 months. a7a45e9adb57476de1eb1ae5613d2098 0000-0001-9656-6751 Alexander Smith Alexander Smith true false 2024-09-27 HSOC 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. Journal Article Journal of Stroke and Cerebrovascular Diseases 33 12 108023 Elsevier BV 1052-3057 Morbidity; Patient Reported Outcome; PROM; Stroke 1 12 2024 2024-12-01 10.1016/j.jstrokecerebrovasdis.2024.108023 COLLEGE NANME Health and Social Care School COLLEGE CODE HSOC Swansea University Another institution paid the OA fee 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. 2024-10-10T14:07:02.0974393 2024-09-27T16:32:22.0001454 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Therapies Amber E Corrigan 0000-0003-0636-0114 1 Marie AG Verstraete 2 Ben Carter 3 Alexander Smith 0000-0001-9656-6751 4 Anna Pennington 5 Jonathan Hewitt 6 67848__32585__dc91e466a5d64bc08f66baaac968869f.pdf 67848.VoR.pdf 2024-10-10T14:05:30.3736747 Output 745184 application/pdf Version of Record true Crown Copyright © 2024. This is an open access article under the CC BY license. true eng http://creativecommons.org/licenses/by/4.0/
title	MORe PREcISE: Longitudinal patient reported outcome measures in stroke at 3 and 6 months.
spellingShingle	MORe PREcISE: Longitudinal patient reported outcome measures in stroke at 3 and 6 months. Alexander Smith
title_short	MORe PREcISE: Longitudinal patient reported outcome measures in stroke at 3 and 6 months.
title_full	MORe PREcISE: Longitudinal patient reported outcome measures in stroke at 3 and 6 months.
title_fullStr	MORe PREcISE: Longitudinal patient reported outcome measures in stroke at 3 and 6 months.
title_full_unstemmed	MORe PREcISE: Longitudinal patient reported outcome measures in stroke at 3 and 6 months.
title_sort	MORe PREcISE: Longitudinal patient reported outcome measures in stroke at 3 and 6 months.
author_id_str_mv	a7a45e9adb57476de1eb1ae5613d2098
author_id_fullname_str_mv	a7a45e9adb57476de1eb1ae5613d2098_***_Alexander Smith
author	Alexander Smith
author2	Amber E Corrigan Marie AG Verstraete Ben Carter Alexander Smith Anna Pennington Jonathan Hewitt
format	Journal article
container_title	Journal of Stroke and Cerebrovascular Diseases
container_volume	33
container_issue	12
container_start_page	108023
publishDate	2024
institution	Swansea University
issn	1052-3057
doi_str_mv	10.1016/j.jstrokecerebrovasdis.2024.108023
publisher	Elsevier BV
college_str	Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id	facultyofmedicinehealthandlifesciences
hierarchy_top_title	Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id	facultyofmedicinehealthandlifesciences
hierarchy_parent_title	Faculty of Medicine, Health and Life Sciences
department_str	School of Health and Social Care - Therapies{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Therapies
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description	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.
published_date	2024-12-01T14:07:02Z
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MORe PREcISE: Longitudinal patient reported outcome measures in stroke at 3 and 6 months.

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