A Pharmacist-Led Stroke Education and Screening Program for Community-Dwelling Older Adults

2019 ◽  
Vol 34 (2) ◽  
pp. 127-142
Author(s):  
Marketa Marvanova ◽  
Paul Jacob Henkel
Keyword(s):  
Risk Factors ◽  
Health Status ◽  
Stroke Prevention ◽  
Stroke Risk ◽  
Community Dwelling ◽  
Warning Signs ◽  
Secondary Stroke Prevention ◽  
Stroke Risk Factors ◽  
Stroke Knowledge ◽  
Study Questionnaire

OBJECTIVES: To deliver a pharmacist-led education and screening for community-dwelling residents, assess the effect of this initiative on knowledge of stroke risk factors and warning signs, and evaluate the stroke-knowledge and risk-assessment questionnaire as a tool to identify stroke-related health status and identify need(s) for specific clinical intervention(s) to decrease risk.<br/> DESIGN: The 70-minute-long event comprised: brief introduction/informed consent, baseline assessment of stroke knowledge, completion of study questionnaire, single blood pressure and heart rate readings, presentation, question-and-answer session, postsurvey questionnaire items.<br/> SETTING: Four faith-based institutions in the Midwest.<br/> PARTICIPANTS: Independent community-dwelling adults 18 years of age and older (N = 97), 89.7% 60 years of age and older.<br/> INTERVENTIONS: Thirty-minute presentation followed by question-and-answer session on ischemic stroke. Screening for primary and secondary stroke-prevention status using study questionnaire and vital signs.<br/> MAIN OUTCOME MEASURE(S): Stroke knowledge regarding modifiable stroke-risk factors and acute stroke-warning signs, individual primary/secondary stroke-prevention status.<br/> RESULTS: Postintervention, mean number of modifiable stroke risk factors (2.6 ± 0.8) and warning signs (2.6 ± 0.8) named improved from preintervention (P < 0.001) including for most subgroups (i.e., self-reported hypertension, atrial fibrillation [AF], or high number of personal risk factors). Needs for improved primary/secondary prevention were identified for blood-measure control and antilipidemic therapy. No disparity was observed regarding thrombotic therapy in participants with AF.<br/> CONCLUSION: The program was resource-efficient, involved student pharmacists, improved immediate stroke-related knowledge of participants including those with increased risk(s) of stroke, and demonstrated value for evaluating stroke-related health status and identifying need for primary and secondary stroke prevention.

scholarly journals Knowledge and Perception of Stroke: A Population-Based Survey in Uganda

ISRN Stroke ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Jane Nakibuuka ◽  
Martha Sajatovic ◽  
Elly Katabira ◽  
Edward Ddumba ◽  
Jayne Byakika-Tusiime ◽  
...  
Keyword(s):  
Risk Factors ◽  
Population Survey ◽  
Stroke Risk ◽  
Large Population ◽  
Population Based ◽  
Traditional Healers ◽  
Warning Signs ◽  
Stroke Event ◽  
Stroke Risk Factors ◽  
Stroke Knowledge

Purpose. This study, designed to complement a large population survey on prevalence of stroke risk factors, assessed knowledge and perception of stroke and associated factors. Methods. A population survey was conducted in urban Nansana and rural Busukuma, Wakiso district, central Uganda. Adult participants selected by multistage stratified sampling were interviewed about selected aspects of stroke knowledge and perception in a pretested structured questionnaire. Results. There were 1616 participants (71.8% urban; 68.4% female; mean age: 39.6 years ± 15.3). Nearly 3/4 did not know any stroke risk factors and warning signs or recognize the brain as the organ affected. Going to hospital (85.2%) was their most preferred response to a stroke event. Visiting herbalists/traditional healers was preferred by less than 1%. At multivariable logistic regression, good knowledge of stroke warning signs and risk factors was associated with tertiary level of education (OR 4.29, 95% CI 2.13–8.62 and OR 5.96, 95% CI 2.94–12.06), resp.) and self-reported diabetes (OR 1.97, 95% CI 1.18–3.32 and OR 1.84, 95% CI 1.04–3.25), resp.). Conclusion. Knowledge about stroke in Uganda is poor although the planned response to a stroke event was adequate. Educational strategies to increase stroke knowledge are urgently needed as a prelude to developing preventive programmes.

Abstract TP203: Reducing Stroke Burden in Uganda

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Mark Kaddumukasa ◽  
Jane Nakibuuka ◽  
James Kayima ◽  
Elly Katabira ◽  
Carol Blixen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Stroke Risk ◽  
Growth Patterns ◽  
Warning Signs ◽  
Clear Understanding ◽  
Stroke Risk Factor ◽  
Stroke Risk Factors ◽  
Study Participants ◽  
Stroke Knowledge

Background: Stroke is a neurological condition with rapidly increasing burden in many low- and middle-income countries. Africa is particularly hard-hit due to rapid population growth, patterns of industrialization, adoption of harmful western diets, and increased prevalence of risk factors such as hypertension and obesity. Reducing stroke risk factors and teaching people to respond to stroke warning signs can prevent stroke and reduce burden. However, being able to address gaps in knowledge and improving both preventative and early-response care requires a clear understanding of practical and potentially modifiable topics. Methods: A cross sectional survey was conducted in urban Mukono district in central Uganda. Through a systematic sampling method, data were gathered from 440 adult participants who were interviewed about selected aspects of stroke knowledge, attitudes and perception, using a pretested structured questionnaire. Results: Of the 440 study participants enrolled for this study nearly 52% correctly reported that stroke involves the brain, while 57% reported that stroke is preventable. Majority of the participants 75.7% reported stress as a contributing factor. Only 45.7% of the study participants reported hypertension as a risk factor. Only two (0.5%) study participants identified cigarette smoking as a stroke risk factor. Of the eighty six study participants with hypertension only 39.5% knew hypertension as a risk factor and only 10.7% knew three or more stroke risk factors. Conclusion: Stroke knowledge is poor in urban Uganda. Individuals with hypertension had poor knowledge regarding stroke in spite their high risk for stroke. Stress and hypertension are the leading perceived risk factors in our settings. While stress is highly reported as a stroke risk factor in this study hypertension is likely a more amenable and practical intervention target.

Abstract P886: Differences in Medication Utilization for Secondary Stroke Prevention Between Ghanaian Stroke Patients and Stroke Patients in the United States

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Esther Olasoji ◽  
FRED S SARFO ◽  
Alexis Simpkins
Keyword(s):  
Risk Factors ◽  
Stroke Prevention ◽  
Stroke Risk ◽  
The United States ◽  
Rural Setting ◽  
Secondary Stroke Prevention ◽  
Stroke Patients ◽  
Stroke Risk Factors ◽  
Medication Utilization ◽  
Oral Agents

Introduction: Optimization of secondary stroke prevention is an essential part of stroke care globally. We sought to assess differences in medication utilization between African Americans (AA), Non-Hispanic Whites (NW), and Ghanaians in addition to effects related to location of residence (rural versus urban). Methods: Data from the UFHealth institutional stroke database and the Kumasi, Ghana Stroke Survivors Registry between 01/2014 and 11/2019 provided a dataset of adult patients diagnosed with stroke from both locations. Multivariate regression analysis identified differences between country of origin, race, patient demographics, location of residence, stroke risk factors, and clinical management following stroke. Results: Of the 5519 patients studied, the median age was 66 (IQR 45 - 87), 16% were AA, 19% Ghanaian, 66% NW, and 51% were male. After controlling for age, sex, stroke type, and stroke risk factors, we found that in comparison to the AA and NW, patients from Ghana were more likely to be prescribed angiotensin converting enzyme (ACE) inhibitors (OR 1.42, 1.05-1.93 95% CI), angiotensin receptor blockers (ARB) (OR 18.36, 13.08-25.78 95% CI), calcium channel blockers (CCB) (OR 8.35, 6.30-11.08 95% CI), statin (OR 3.26, 2.26-4.59 95% CI), anti-diabetic oral agents (OR 7.18, 4.21-12.27 95% CI); less likely to be prescribed anticoagulant (OR 0.22, 0.12-0.40 95% CI), beta blockers (BB) (OR 0.15, 0.11-0.21 95% CI), and insulin (OR 0.11, 0.06-0.20 95% CI). In comparison to AA, Ghanaians were more likely to be prescribed statin (OR 3.06, 1.93-4.86 95% CI), ARBs (OR 22.87, 13.85-37.79 95% CI), CCBs (OR 5.83, 3.94-8.62 95% CI), anti-diabetic oral agents (OR 8.89, 4.25-18.59 95% CI); less likely to live in an urban vs rural setting (OR 0.64, 0.46-0.89 95% CI), be prescribed anticoagulant (OR 0.28, 0.14-0.55 95% CI), BBs (OR 0.13, 0.0.09-0.19 95% CI), and insulin (OR 0.11, 0.05-0.23 95% CI). Conclusion: In conclusion, we found significant differences in the prevalence of medications prescribed for stroke prevention between Ghana and the U.S. Further research is needed to determine if these differences result in consequential differences in stroke reoccurrence between these populations.

scholarly journals An Examination of Stroke-Related Knowledge in Male Stroke Survivors Living in the South Carolina Stroke Belt

2014 ◽  
Vol 8 (6) ◽  
pp. 532-537 ◽  
Author(s):  
Charles Ellis
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Risk Factor ◽  
Racial Differences ◽  
Stroke Prevention ◽  
Stroke Risk ◽  
Stroke Survivors ◽  
Stroke Risk Factor ◽  
Stroke Risk Factors ◽  
Stroke Knowledge

Racial differences have been observed in stroke-related knowledge and knowledge of specific stroke risk factors and stroke prevention practices. Using data from 134 male stroke survivors, racial differences in overall knowledge, risk factor knowledge, and stroke prevention practices were examined using the Stroke Knowledge Test. Knowledge that diabetes doubles ones risk of stroke was present in 48% of the participants, while knowledge of aspirin in the prevention of stroke by stopping blood clot formation was reported in 83% of the participants. Findings indicate participants were knowledgeable that obesity increased risk of stroke (71%) and high blood pressure was the most important stroke risk factor (70%). Participants indicated knowledge that diet, exercise, and controlling blood pressure and cholesterol reduces risk of stroke (86%). In regression models, there were no significant race differences in overall stroke knowledge or the odds of knowledge of information related to stroke risk factors and stroke prevention practices after adjusting for age, education, and marital status. Although stroke-related knowledge did not differ by race, stroke survivors exhibited gaps in stroke knowledge particularly of knowledge of common risk factors. These factors should be considered in approaches to improve stroke-related knowledge in all stroke survivors.

scholarly journals Do Multiple Stroke-Related Educational Opportunities Enhance Stroke Knowledge among Students Enrolled in Communication Sciences and Disorders Programs?

2008 ◽  
Author(s):  
Kristen Lankford ◽  
E. Marshall ◽  
Amanda Pittman ◽  
Charles Ellis
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Early Warning ◽  
Stroke Risk ◽  
Warning Signs ◽  
Stroke Risk Factors ◽  
Early Warning Signs ◽  
Multiple Stroke ◽  
Level Of Instruction ◽  
Stroke Knowledge

Purpose: Stroke education modules have been added to medical school curriculums to improve stroke knowledge in graduate physicians, and this has resulted in positive outcomes. These findings suggest that similar strategies may be successful in graduate programs such as Communication Sciences and Disorders (CSD). The purpose of this study was to examine the impact of multiple stroke-related education opportunities on students enrolled in CSD programs. Methods: Seventy-six first and second year students enrolled in a Communication Sciences and Disorders program completed a survey of stroke risk factors and early warning signs of stroke. Results: Risk factor knowledge - 97% identified smoking as a risk factor; 61% identified diabetes; 90% identified high cholesterol; 84% identified age, and 90% identified physical inactivity. Students varied in their recognition of diabetes as a stroke risk factor based on their level of instruction. Early warning signs and first response knowledge - 83% recognized sudden confusion or trouble speaking; 100% recognized sudden facial, arm or leg weakness; 83% recognized sudden vision loss; 76% recognized sudden trouble walking; and 75% recognized sudden headache as early warning signs of stroke. Seventy-nine percent recognized calling 9-1-1 as the appropriate first action. Students varied in their recognition of sudden trouble walking and severe headache as an early warning sign of stroke based on their level of instruction. Conclusions: Most students recognized individual stroke risk factors and early warning signs, but few recognized multiple risk factors and warning signs. Multiple education opportunities appear to enhance student recognition of risk factors and warning signs.

scholarly journals Hispanic Secondary Stroke Prevention Initiative Design: Study Protocol and Rationale for a Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Olveen Carrasquillo ◽  
BreAnne Young ◽  
Stuti Dang ◽  
Orieta Fontan ◽  
Natalie Ferras ◽  
...  
Keyword(s):  
Risk Factors ◽  
Randomized Controlled Trial ◽  
Stroke Prevention ◽  
Stroke Risk ◽  
Controlled Trial ◽  
Text Messages ◽  
South Florida ◽  
Secondary Stroke Prevention ◽  
Stroke Risk Factors ◽  
Randomized Controlled

BACKGROUND Hispanic-Latino populations face a disproportionate stroke burden and are less likely to have sufficient control over stroke risk factors in comparison with other ethnic populations. A promising approach to improving chronic health outcomes has been the use of community health workers (CHWs). OBJECTIVE The objective of this randomized controlled trial is to evaluate the effectiveness of a CHW intervention among Latino patients at risk of recurrent stroke. METHODS The Hispanic Secondary Stroke Prevention Initiative (HiSSPI) is a randomized clinical trial of 300 Latino participants from South Florida who have experienced a stroke within the last 5 years. Participants randomized into the CHW intervention arm receive health education and assistance with health care navigation and social services through home visits and phone calls. The intervention also includes a mHealth component in which participants also receive daily text messages (short message service). The primary outcome is change in systolic blood pressure at 12 months. Other secondary outcomes include changes in low-density lipoprotein, glycated hemoglobin, and medication adherence. RESULTS Study enrollment began in 2015 and will be completed by the end of 2018. The first results are expected to be submitted for publication in 2020. CONCLUSIONS HiSSPI is one of the first randomized controlled trials to examine CHW-facilitated stroke prevention and will provide rigorous evidence on the impact of CHWs on secondary stroke risk factors among Latino individuals who have had a stroke. CLINICALTRIAL ClinicalTrials.gov NCT02251834; https://clinicaltrials.gov/ct2/show/NCT02251834 (Archived by WebCite at http://www.webcitation.org/72DgMqftq) INTERNATIONAL REGISTERED REPOR RR1-10.2196/11083

scholarly journals Does Socioeconomic Position Affect Knowledge of the Risk Factors and Warning Signs of Stroke in the WHO European Region? A Systematic Literature Review

2020 ◽  
Author(s):  
Katie Stack ◽  
Wendy Robertson ◽  
Clare Blackburn
Keyword(s):  
Risk Factors ◽  
Socioeconomic Position ◽  
Stroke Risk ◽  
Educational Interventions ◽  
Warning Signs ◽  
European Region ◽  
Free Text ◽  
Stroke Risk Factors ◽  
Mesh Terms ◽  
Increasing Knowledge

Abstract Background: Strokes are one of the leading causes of death worldwide. People with a lower socioeconomic position (SEP) (i.e. with regards to education, income and occupation) are at a higher risk of having a stroke and have worse clinical outcomes compared to the general population. Good knowledge levels about stroke risk factors and warning signs are key to prolonging life and reducing health issues caused by stroke. This systematic review examined differences in knowledge of stroke risk factors and warning signs with regards to SEP in the WHO European region. Methods: MEDLINE, Embase, Web of Science, PsycINFO and CINAHL were systematically searched using appropriate Medical Subject Headings (MeSH) terms and free text, combining search terms with Boolean operators. Two independent reviewers selected studies in two stages (title and abstract, and full-text), and screened reference lists of included studies. Only studies in English and based in the WHO European region were included. Results: Screening identified 2,118 records. In the final review, 20 articles were included, with 67,309 study participants between them. Out of 17 studies that looked at stroke risk factors, 11 found increasing knowledge to be associated with higher SEP, four found no difference by SEP, one showed a mixed pattern and one outlier study found increasing knowledge of risk factors to be associated with a lower SEP. Out of 19 studies that looked at stroke warning signs or symptoms, 15 found there to be better knowledge of warning signs with a higher SEP, three found there to be no difference, and the same outlier study found increasing knowledge of warning signs with a lower SEP. Studies that seemed to have a higher quality rating found increasing knowledge of stroke with a higher SEP. A meta-analysis was not possible due to heterogeneity of studies. Conclusions: In the WHO European region, better knowledge of stroke risk factors and warning signs is associated with a higher SEP. Public health campaigns and educational interventions aiming to increase stroke knowledge should be targeted at people with a lower SEP.

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