MORe PREcISE: Longitudinal patient reported outcome measures in stroke at 3 and 6 months.

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2024-09-19 DOI:10.1016/j.jstrokecerebrovasdis.2024.108023

Amber E Corrigan MBBS BSc , Marie AG Verstraete MBChB , Ben Carter PhD , Alexander Smith MA MRCOT , Anna Pennington BSc , Jonathan Hewitt MBBS PhD MSc FRCP (Glas)

{"title":"MORe PREcISE: Longitudinal patient reported outcome measures in stroke at 3 and 6 months.","authors":"Amber E Corrigan MBBS BSc , Marie AG Verstraete MBChB , Ben Carter PhD , Alexander Smith MA MRCOT , Anna Pennington BSc , Jonathan Hewitt MBBS PhD MSc FRCP (Glas)","doi":"10.1016/j.jstrokecerebrovasdis.2024.108023","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and Purpose</h3><div>Post-stroke morbidity is common, but little is known about the burden on patients’ lives from their own perspective. Understanding morbidity from the point of view of the patient may support targeted intervention in post-stroke recovery. This study used a stroke specific Patient Reported Outcome Measure (PROM) containing Mental health (MH) and Physical Health (PH) domains and 5 stroke specific questions. We aimed to consider trends over a 6-month period and further assess the association between the MH and PH measures and common clinical measures.</div></div><div><h3>Methods</h3><div>A multicenter prospective cohort study was conducted at 19 hospital sites across England and Wales. Patients were enrolled from August 2018 to September 2019. Clinical measures and PROMs were assessed at three timepoints: acutely following the index stroke, at 3 and 6-months post-stroke. Clinical measures and PROMs were assessed in each of these points.</div></div><div><h3>Results</h3><div>Physical health PROM domains show significant gradual improvement across the study period (χ<sup>2</sup> 42.6312, p<0.0001), whereas cognitive function domains (χ<sup>2</sup> 3.7849, p<0.875) did not echo this trend. All clinical measures (GAD-7, PHQ9, MoCA, MRS) were associated with poorer PROM MH outcomes, (aMD -4.4, CI -0.59, -0.29, <em>p</em>≤0.001, aMD -0.45, CI -0.59, -0.32, <em>p</em>=<0.001, aMD 0.75, CI 0.56, 0.95, aMD -1.91, CI -2.41, -1.47, <em>p</em>≤0.001). Clinical measures of disability, as per the MRS, are associated with poor PROM PH scores (aMD -0.57, 95% CI -0.94, -0.20, <em>p</em>=0.003).</div></div><div><h3>Conclusions</h3><div>This research indicates there is unmet cognitive burden in stroke survivors. PROMs may be able to measure unmet more discretely than common clinical tools that are used post-stroke. Further research and guidance on how to integrate PROMs into current clinical frameworks is essential.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"33 12","pages":"Article 108023"},"PeriodicalIF":2.0000,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Stroke & Cerebrovascular Diseases","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1052305724004683","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NEUROSCIENCES","Score":null,"Total":0}

引用次数: 0

Abstract

Background and Purpose

Post-stroke morbidity is common, but little is known about the burden on patients’ lives from their own perspective. Understanding morbidity from the point of view of the patient may support targeted intervention in post-stroke recovery. This study used a stroke specific Patient Reported Outcome Measure (PROM) containing Mental health (MH) and Physical Health (PH) domains and 5 stroke specific questions. We aimed to consider trends over a 6-month period and further assess the association between the MH and PH measures and common clinical measures.

Methods

A multicenter prospective cohort study was conducted at 19 hospital sites across England and Wales. Patients were enrolled from August 2018 to September 2019. Clinical measures and PROMs were assessed at three timepoints: acutely following the index stroke, at 3 and 6-months post-stroke. Clinical measures and PROMs were assessed in each of these points.

Results

Physical health PROM domains show significant gradual improvement across the study period (χ² 42.6312, p<0.0001), whereas cognitive function domains (χ² 3.7849, p<0.875) did not echo this trend. All clinical measures (GAD-7, PHQ9, MoCA, MRS) were associated with poorer PROM MH outcomes, (aMD -4.4, CI -0.59, -0.29, p≤0.001, aMD -0.45, CI -0.59, -0.32, p=<0.001, aMD 0.75, CI 0.56, 0.95, aMD -1.91, CI -2.41, -1.47, p≤0.001). Clinical measures of disability, as per the MRS, are associated with poor PROM PH scores (aMD -0.57, 95% CI -0.94, -0.20, p=0.003).

Conclusions

This research indicates there is unmet cognitive burden in stroke survivors. PROMs may be able to measure unmet more discretely than common clinical tools that are used post-stroke. Further research and guidance on how to integrate PROMs into current clinical frameworks is essential.

查看原文本刊更多论文

更多详情：中风患者 3 个月和 6 个月的纵向报告结果测量。

背景和目的：脑卒中后发病率很高，但从患者的角度来看，他们的生活负担却鲜为人知。从患者的角度了解发病率有助于对脑卒中后的康复进行有针对性的干预。本研究使用了脑卒中患者报告结果量表（PROM），该量表包含心理健康（MH）和身体健康（PH）领域以及 5 个脑卒中特定问题。我们的目的是考虑 6 个月内的趋势，并进一步评估心理健康和身体健康指标与常见临床指标之间的关联：在英格兰和威尔士的 19 家医院开展了一项多中心前瞻性队列研究。患者登记时间为 2018 年 8 月至 2019 年 9 月。临床指标和 PROMs 在三个时间点进行评估：指数卒中后的急性期、卒中后 3 个月和 6 个月。每个时间点都对临床指标和 PROM 进行了评估：结果：在整个研究期间，身体健康 PROM 领域显示出明显的逐步改善（χ2 42.6312，p2 3.7849，pConclusions）：这项研究表明，中风幸存者的认知负担尚未得到满足。与脑卒中后常用的临床工具相比，PROMs 可能能更细致地测量未满足的需求。关于如何将 PROMs 纳入当前临床框架的进一步研究和指导至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.