The Pre-Adaptation of a Stroke-Specific Self-Management Program Among Older Adults

Authors

Timothy Reistetter
Kimberly Hreha
Julianna M Dean
Monique R Pappadis
Rachel R Deer
Chih-Ying Li
Ickpyo Hong
Annalisa Na
Sara Nowakowski
Hashem M Shaltoni
Suresh K Bhavnani

Publication Date

10-1-2023

Journal

Journal of Aging and Health

DOI

10.1177/08982643231152520

PMID

36719035

PMCID

PMC10387498

PubMedCentral® Posted Date

10-1-2023

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Humans, Aged, United States, Stroke Rehabilitation, Self-Management, Medicare, Stroke, Comorbidity, stroke, self-management, visual analytics, adaptation

Abstract

Objectives:

Managing multimorbidity as aging stroke patients is complex; standard self-management programs necessitate adaptations. We used visual analytics to examine complex relationships among aging stroke survivors’ comorbidities. These findings informed pre-adaptation of a component of the Chronic Disease Self-Management Program.

Methods:

Secondary analysis of 2013–2014 Medicare claims with stroke as an index condition, hospital readmission within 90 days (n=42,938), and 72 comorbidities. Visual analytics identified patient subgroups and co-occurring comorbidities. Guided by the framework for reporting adaptations and modifications to evidence-based interventions (FRAME), an interdisciplinary team developed vignettes that highlighted multimorbidity to customize the self-management program.

Results:

There were five significant subgroups (z=6.19, p<.001) of comorbidities such as obesity and cancer. We constructed 6 vignettes based on the 5 subgroups.

Discussion:

Aging stroke patients often face substantial disease-management hurdles. We used visual analytics to inform pre-adaptation of a self-management program to fit the needs of older adult stroke survivors.

Comments

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