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

Autor: Corrigan AE; Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London. Electronic address: amber.corrigan1@nhs.net., Verstraete MA; Stoke Mandeville Hospital, Buckinghamshire NHS Trust, UK., Carter B; Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London., Smith A; Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK., Pennington A; Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK., Hewitt J; Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK; Aneurin Bevan University Health Board, South Wales, UK.
Jazyk: angličtina
Zdroj: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2024 Dec; Vol. 33 (12), pp. 108023. Date of Electronic Publication: 2024 Sep 19.
DOI: 10.1016/j.jstrokecerebrovasdis.2024.108023
Abstrakt: Background and Purpose: Post-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.
Methods: A 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.
Results: Physical health PROM domains show significant gradual improvement across the study period (χ 2 42.6312, p<0.0001), whereas cognitive function domains (χ 2 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).
Conclusions: This 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.
Competing Interests: Declaration of competing interest No conflicts of interest.
(Crown Copyright © 2024. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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