Outpatient practice patterns after stroke hospitalization among neurologists

Bruce Ovbiagele, Oksana Drogan, Walter J. Koroshetz, Pierre Fayad, Jeffrey L. Saver

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

BACKGROUND AND PURPOSE: Care after stroke hospitalization can provide several opportunities to optimize vascular risk reduction. However, not much is known about poststroke practice patterns among neurologists. Such knowledge may help direct specific efforts to improve the impact of practicing neurologists on clinical outcomes after stroke. METHODS: A survey soliciting information on processes of care in the outpatient setting after recent hospitalization for ischemic stroke or transient ischemic attack was mailed to a random sample of 833 US and Canadian neurologistmembers of the American Academy of Neurology. RESULTS: A total of 475 (57%) responses were received. Practice demographics of survey responders and nonresponders were largely similar. Fourteen percent of respondents identified themselves as vascular neurologists. Overall, respondents reported frequently checking for medication adherence and counseling patients on lifestyle modification. However, neurologists reported screening more frequently for diabetes, hypertension, and dyslipidemia than actually treating these conditions (all P<0.0001) Vascular neurologists were more likely than general neurologists to screen for hypertension (97% versus 86%, P≤0.016), dyslipidemia (94% versus 68%, P<0.001), diabetes (89% versus 62%, P<0.001), and sleep apnea (94% versus 79%, P≤0.007) as well as to treat hypertension (71% versus 45%, P<0.001), dyslipidemia (82% versus 50%, P<0.001), diabetes (45% versus 21%, P<0.001), and current smoking (77% versus 59%, P≤0.005). Neurologists with mostly government-insured and uninsured patients were significantly more likely to engage in vascular risk reduction treatment than neurologists with mostly commercially insured patients. CONCLUSIONS: Self-reported rates of screening and treatment of major vascular risk factors by most neurologists after stroke hospitalization are substantial but not universal. Bridging knowledge gaps or adopting a systematic management approach in coordination with primary care physicians could help optimize poststroke care.

Original languageEnglish (US)
Pages (from-to)1850-1851
Number of pages2
JournalStroke
Volume39
Issue number6
DOIs
StatePublished - Jun 1 2008

Keywords

  • Adherence
  • Ischemic stroke
  • Neurologists
  • Practice patterns

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

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