Clinical Guidelines for Acute Stroke Management - Living on the EDge

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adults living at home with diabetes, however, no benefits were noted <strong>for</strong> those with hypertension. 449 However, the other more robust review found improvements in number of pills taken in four of the five included studies, but only modest clinical benefits were reported in one of the three trials <strong>for</strong> those with hypertension. 450 > One study found a program of initiating tailored secondary prevention medications while in hospital lead to improved rates of adherence both prior to discharge and 3 months after discharge. 394 While only small numbers are reported, making it difficult to establish secondary incidence, commencing strategies early may be a key to improving medication adherence and improve secondary prevention along with regular follow up. The available studies suggest there is no single intervention that is proven to work across all patients, conditions and settings. Hence, specific interventions should be tailored to each individual’s situation after stroke. In<strong>for</strong>mation specific to general practice has been developed and provides further practical advice. 451 However, further studies specific to stroke are needed. 7.9 CONCORDANCE WITH MEDICATION GRADE LEVEL Interventions to promote adherence to medication regimes are often complex and should include one or more of the following: - in<strong>for</strong>mation, reminders, self-monitoring, rein<strong>for</strong>cement, counselling, family therapy; B Level I 446-448 - reduction in the number of daily doses; B Level I 446, 447 - multi-compartment medication compliance device; C Level I 449, 450 Section 7 Secondary Prevention 51
8 DISCHARGE PLANNING, TRANSFER OF CARE AND INTEGRATED COMMUNITY CARE Section 8 Discharge Planning, Transfer of Care and Integrated Community Care Good discharge planning is crucial <strong>for</strong> successful reintegration into the community as well as effective and efficient use of limited hospital resources. While it is known that the transfer of responsibility <strong>for</strong> management from inpatient to the community can be difficult, insufficient attention and resources are often provided <strong>for</strong> this process. One group that is of particular concern is younger stroke survivors (i.e.
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Stop stroke. Save lives. End Suffer
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About the National Stroke</
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SECTION 6: PREVENTION AND MANAGEMEN
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KEY MESSAGES iiKey Messages This se
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1. Organisation of Services Message
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viKey Messages 3.2: Triage in emerg
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Key Messages c) Patients who fail t
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xKey Messages > avoiding excessive
Page 17 and 18: Key Messages b) The stroke survivor
Page 19 and 20: 2Introduction > Nurses perf
Page 21 and 22: 4Introduction studies were identifi
Page 23 and 24: 1 ORGANISATION OF SERVICES 1 Organi
Page 26 and 27: CONSUMER 1.3 ORGANISATION OF CARE F
Page 28 and 29: 1.8 Information an
Page 30 and 31: 1.11 Standardised assessment Comple
Page 32 and 33: CONSUMER 1.13 STROKE SERVICE IMPROV
Page 34 and 35: 3 EARLY ASSESSMENT AND DIAGNOSIS Th
Page 36 and 37: A notification system between emerg
Page 38 and 39: 3.4 INVESTIGATIONS GRADE LEVEL a) T
Page 40 and 41: Intravenous rt-PA was licensed by t
Page 42 and 43: 4.1.3 Antithrombotic therapy Eviden
Page 44 and 45: Surgical management Surgical manage
Page 46 and 47: 4.3.4 NEUROPROTECTIVE AGENTS GRADE
Page 48 and 49: intense therapy, further high quali
Page 50 and 51: of very early versus delayed mobili
Page 52 and 53: The first step in planning manageme
Page 54 and 55: 5.7 INCONTINENCE GRADE LEVEL a) All
Page 56 and 57: 6 PREVENTION AND MANAGEMENT OF COMP
Page 58 and 59: 6.2 DEEP VENOUS THROMBOSIS (DVT) AN
Page 60 and 61: 7 SECONDARY PREVENTION 7.1 Behaviou
Page 62 and 63: diuretic. 398 A subsequent trial co
Page 64 and 65: There remains uncertainty about the
Page 66 and 67: asymptomatic stenosis
Page 70 and 71: equires a home visit. Factors to co
Page 72 and 73: 8.6 Community rehabilitation Often
Page 74 and 75: 9 COST AND SOCIOECONOMIC IMPLICATIO
Page 76 and 77: stroke units that used care pathway
Page 78 and 79: 9.2.5 Carer training One study was
Page 80 and 81: APPENDIX A: Guideline development p
Page 82 and 83: d) If the search was for</s
Page 84 and 85: Consultation Public consultation wa
Page 86 and 87: A total of 44 consumers were involv
Page 88 and 89: A systematic review of the above di
Page 90 and 91: GLOSSARY AND ABBREVIATIONS Activiti
Page 92 and 93: REFERENCES 1 National Strok
Page 94 and 95: 57 Larson J, Franzén Dahlin A, Bil
Page 96 and 97: 109 Ferro JM, Pinto AN, Falcao I, e
Page 98 and 99: 157 Gubitz G, Sandercock P, Counsel
Page 100 and 101: 207 Palesch YY, Hill MD, Ryckborst
Page 102 and 103: 262 Bamford J, Den
Page 104 and 105: 317 Anderson CS, Hackett ML, House
Page 106 and 107: 367 He FJ, MacGregor GA. Effect of
Page 108 and 109: 415 Saxena R, Koudstaal P. Anticoag
Page 110 and 111: 466 Glass TA, Berkman LF, Hiltunen
Page 112: 517 Sesso HD, Chen RS, L'Italien GJ
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