Impact of a Nursing Educational Consultation on the Patient's Adherence to Their Post-stroke Care Plan.
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: nursing educational consultation.
- Who it may be relevant to
- Registry conditions: Stroke, Patient Education. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- France
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Impact of a Nursing Consultation at the End of Hospitalization on Adherence to the Post-stroke Care Plan for Patients Admitted to the Vascular Neurology Unit
Overview
This prospective, single-center, randomized study will evaluate the impact of implementing an educational nursing consultation at the end of hospitalisation for stroke patients returning home on overall adherence to stroke-related medication during the 4-month follow-up visit.
Detailed description
Stroke is the leading cause of acquired disability in adults and represents a public health problem in terms of frequency, severity, and cost.
In France, the prevalence of stroke is estimated at 1.6%, with about 150,000 new cases each year. The risk of recurrence after a stroke remains high, nearly 6% at 1 year and 13% at 5 years. Some strokes and their recurrences are preventable through targeted prevention, particularly addressing cardiovascular risk factors.
The care pathway for a patient suffering from a stroke or TIA in a medical service includes:
* acute care in stroke units, which allows more than half of patients to return home * a post-stroke consultation, 3 to 6 months after the stroke. According to the WHO, 50% of patients with chronic illnesses poorly adhere or adhere little to their treatments. Interventions are necessary to improve adherence to drug and rehabilitation therapies. They raise awareness of the risks of relapse through a better understanding of the disease and control of risk factors. Increased efforts to enhance awareness of stroke and secondary prevention drug treatments are warranted.
In the stroke care pathway, therapeutic education is an integral part of secondary prevention. It is an essential complement to the management of patients following a stroke and should be initiated as early as possible after the acute phase, hence during the stay in the neurological intensive care unit. However, ETP programs are scarce within general hospitals. Of about twenty programs listed in Nouvelle Aquitaine, only a quarter are accessible in general hospitals. The implementation of a nursing educational consultation, at the end of the acute management of the stroke, will allow for conveying the key messages of secondary prevention.
The investigators of this research propose to study the impact of this nursing educational consultation on the patient's adherence to their post-stroke care plan.
Interventions
- Other nursing educational consultation
At the end of hospitalization, the patient will receive a nursing education consultation prior to discharge. This consultation will provide personalized information regarding stroke pathology, its mechanisms and etiology, medication treatments, personal vascular risk factors, and the implementation of the care plan (rehabilitation, additional examinations). Discharge documents are provided at the end of this consultation.
Primary outcome measures
- Measurement of the proportion of patients with high adherence to their prescribed medications after stroke, upon returning home [Time frame: 4 months]
Secondary outcome measures (12)
- Description of the specfic therapeutic adherence [Time frame: 4 & 12 months]
- Evaluation of Patient adherence to the post-stroke care plan (1) [Time frame: 4 & 12 months]
- Evaluation of Patient adherence to the post-stroke care plan (2) [Time frame: 4 & 12 months]
- Evaluation of Patient adherence to the post-stroke care plan (3) [Time frame: 4 & 12 months]
- Evaluation of Patient adherence to the post-stroke care plan (4) [Time frame: 4 & 12 months]
- Assessment of the patient's knowledge about stroke [Time frame: 4 & 12 months]
- Evaluation of secondary prevention and vascular risk factors (1) [Time frame: 4 & 12 months]
- Evaluation of secondary prevention and vascular risk factors (2) [Time frame: 4 & 12 months]
- Evaluation of secondary prevention and vascular risk factors (3) [Time frame: 4 & 12 months]
- Evaluation of secondary prevention and vascular risk factors (4) [Time frame: 4 & 12 months]
- Evaluation of secondary prevention and vascular risk factors (5) [Time frame: 4 & 12 months]
- Evaluation of secondary prevention and vascular risk factors (6) [Time frame: 4 & 12 months]
Eligibility criteria
Inclusion criteria
- Patients admitted to the Neurovascular Unit (UNV) of CHCB for ischemic stroke and/or hemorrhagic stroke confirmed by brain imaging and/or TIA with an ABCD2 score >5,
- Patients whose discharge orientation is a return home
- Age ≥ 18 years
- NIHSS < 15
- Montreal Cognitive Assessment (MoCa) > 21/30
- Free and informed consent signed by the patient.
- Person affiliated with or a beneficiary of a social security scheme
Exclusion criteria
- Patients admitted for mechanical thrombectomy, outside the Basque Coast Hospital (CHCB)
- Rankin score estimated at discharge ≥ 4
- Patients requiring assistance from a third party at home for the management of their medication or with stroke follow-up at Prado
- Patients placed under protection measures
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Single blind
- Primary purpose
- Prevention
Study locations
France · 1 center
- Centre Hospitalier de la Côte Basque — Bayonne
Identifiers
NCT: NCT07524036 · CHUBX 2024/112