Randomized, Controlled Trial of an Intervention to Enable Stroke Survivors Throughout the Los Angeles County Safety Net to 'Stay With the Guidelines'
| Autor: | Thomas L. Anderson, Robert Bryg, Jeffrey L. Saver, Jeffrey J. Guterman, Sandra Gross-Schulman, Sylvia Beanes, Andrea S. Jones, Amytis Towfighi, Barbara G. Vickrey, William E. Cunningham, Honghu Liu, Eric M. Cheng, Nerses Sanossian, Susan L. Ettner |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Gerontology medicine.medical_specialty Psychological intervention Article law.invention Randomized controlled trial Risk Factors law Intervention (counseling) Outcome Assessment Health Care Health care Secondary Prevention medicine Humans Life Style Stroke Aged Aged 80 and over Chronic care Self-management business.industry Public health Middle Aged medicine.disease Los Angeles Self Care Self-Help Groups Treatment Outcome Hypertension Emergency medicine Costs and Cost Analysis Patient Compliance Self Report Cardiology and Cardiovascular Medicine business |
| Zdroj: | Circulation: Cardiovascular Quality and Outcomes. 4:229-234 |
| ISSN: | 1941-7705 1941-7713 0086-1081 |
| DOI: | 10.1161/circoutcomes.110.951012 |
| Popis: | Background— Stroke is the leading cause of adult disability. Inpatient programs optimize secondary stroke prevention care at the time of hospital discharge, but such care may not be continued after hospital discharge. Methods— To improve the delivery of secondary stroke preventive services after hospital discharge, we have designed a chronic care model–based program called SUSTAIN (Systemic Use of STroke Averting INterventions). This care intervention includes group clinics, self-management support, report cards, decision support through care guides and protocols, and coordination of ongoing care. The first specific aim is to test, in a randomized, controlled trial, whether SUSTAIN improves blood pressure control among an analytic sample of 268 patients with a recent stroke or transient ischemic attack discharged from 4 Los Angeles County public hospitals. Secondary outcomes consist of control of other stroke risk factors, lifestyle habits, medication adherence, patient perceptions of care quality, functional status, and quality of life. A second specific aim is to conduct a cost analysis of SUSTAIN from the perspective of the Los Angeles County Department of Health Services by using direct costs of the intervention, cost equivalents of associated utilization of county system resources, and cost equivalents of the observed and predicted averted vascular events. Conclusions— If SUSTAIN is effective, we will have the expertise and findings to advocate for its continued support at Los Angeles County hospitals and to disseminate the SUSTAIN program to other settings serving indigent, minority populations. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT00861081. |
| Databáze: | OpenAIRE |
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