Factors and Behaviors Related to Successful Transition of Care After Hospitalization for Ischemic Stroke

Authors

Chuanhui Dong
Hannah Gardener
Tatjana Rundek
Erika Marulanda
Carolina M Gutierrez
Iszet Campo-Bustillo
Gillian Gordon Perue
Karlon H Johnson
Ralph L Sacco
Jose G Romano
Transitions of Care Stroke Disparities Study (TCSD-S) Investigators

Publication Date

2-1-2023

Journal

Stroke

Abstract

BACKGROUND: Our objective is to describe adoption of the posthospitalization behaviors associated with successful transition of care and related baseline characteristics.

METHODS: This study includes 550 participants in the Transition of Care Stroke Disparities Study, a prospective observational cohort derived from the Florida Stroke Registry. Participants had an ischemic stroke (2018-2021), discharged home or to rehabilitation, with modified Rankin Scale score=0-3 (44% women, 24% Black, 48% White, 26% Hispanic, 35% foreign-born). We collected baseline sociodemographic and clinical characteristics. A structured telephone interview at 30-day postdischarge evaluated outcomes including medication adherence, medical appointment attendance, outpatient therapy, exercise, diet modification, toxic habit cessation, and a calculated composite adequate transition of care measure. Multivariable analyses assessed the association of baseline characteristics with 30-day behaviors.

RESULTS: At 30 days, medication adherence was achieved by 89%, medical appointments by 82%, outpatient therapy by 76%, exercise by 71%, diet modification by 68%, toxic habit cessation by 35%, and adequate transition of care measure by 67%. Successful adequate transition of care participants were more likely to be used full-time (42% versus 31%,

CONCLUSIONS: One in 3 patients did not attain adequate 30-day transition of care behaviors. Their achievement varied substantially among different measures and was influenced by multiple socioeconomic and clinical factors. Interventions aimed at facilitating transition of care from hospital after stroke are needed.

REGISTRATION: URL: https://clinicaltrials.gov/; Unique identifier: NCT03452813.

Keywords

Humans, Female, Male, Ischemic Stroke, Patient Transfer, Aftercare, Pandemics, Treatment Outcome, Patient Discharge, COVID-19, Stroke, Hospitalization, Thrombectomy

Comments

Supplementary Materials

PMID: 36533520