期刊
STROKE
卷 52, 期 9, 页码 E558-E571出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/STR.0000000000000382
关键词
AHA Scientific Statements; aftercare; family practice; internal medicine; primary health care; secondary prevention; stroke; stroke rehabilitation
Primary care teams play a key role in providing poststroke care, focusing on preventing recurrent stroke, improving function, preventing late complications, and enhancing quality of life. Patient-centered primary care involves establishing a foundation for poststroke management, screening for complications, and ensuring ongoing support for patients with functional impairments. Effective management of risk factors and lifestyle modifications are crucial in reducing the risk of recurrent stroke and optimizing outcomes in poststroke care.
Primary care teams provide the majority of poststroke care. When optimally configured, these teams provide patient-centered care to prevent recurrent stroke, maximize function, prevent late complications, and optimize quality of life. Patient-centered primary care after stroke begins with establishing the foundation for poststroke management while engaging caregivers and family members in support of the patient. Screening for complications (eg, depression, cognitive impairment, and fall risk) and unmet needs is both a short-term and long-term component of poststroke care. Patients with ongoing functional impairments may benefit from referral to appropriate services. Ongoing care consists of managing risk factors such as high blood pressure, atrial fibrillation, diabetes, carotid stenosis, and dyslipidemia. Recommendations to reduce risk of recurrent stroke also include lifestyle modifications such as healthy diet and exercise. At the system level, primary care practices can use quality improvement strategies and available resources to enhance the delivery of evidence-based care and optimize outcomes.
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