Primary care an essential first step on the road to recovery for stroke patients

Primary care teams help stroke patients recover as quickly as possible, working to limit recurrent stroke and avoid any further complications. A new scientific statement from the American Heart Association and American Stroke Association examines this role at length, providing key recommendations and emphasizing the importance of patient-centered care.

“In this statement, we affirm in a new way the role of the primary care professional in caring for people with stroke,” Walter N. Kernan, MD, chair of the statement’s writing group and a professor at Yale University School of Medicine, said in a prepared statement. “The core functions of primary care as a specialty include: 1) diagnosis and management of acute symptoms, 2) chronic disease management and 3) disease prevention. Primary care professionals can ensure consistent and comprehensive care for the full needs of patients, including coordinating any additional care or services patients may need from community services providers or from subspecialty health care providers.”

Kernan et al. noted that the risk for recurrent stroke is nearly 8% in the first year after an ischemic stroke. Even after that initial year, the risk is still roughly four times higher than normal.

To limit the risk of recurrent issues, of course, the team has to confirm what caused the stroke. Primary care providers can make an immediate impact by ordering diagnostic tests as needed and working to implement a treatment plan for the patient. As needed, the primary care team can also refer patients to specialists when necessary. If anxiety/depression or post-stroke seizures, for instance, become a concern, the primary care provider may need to lead the charge and ensure that those potential complications are addressed.

The primary care team also helps with maximizing the patient’s function and independence.

“Recovery begins early after stroke, and it can take years for a patient to achieve maximum restoration in function,” the authors wrote. “Motor strength and limb mobility improve rapidly in the first 30 days and reach maximum recovery by ≈4 months when rehabilitation is provided. Restoration of ability to engage in physical activities stretches beyond this time, however, because of brain remodeling, adaptation of compensating strategies, restoration of confidence and use of adaptive equipment.”

The statement also highlights different strategies for managing vascular risk factors and details the many benefits of pursuing quality improvement opportunities. Click here to read the full document in Stroke.

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