Integrated healthcare journal最新文献

{"title":"Effectiveness of a 24-hour access outpatient clinic for patients with chronic conditions in hospital outpatient follow-up: a registry-based controlled cohort study of healthcare utilisation and mortality.","authors":"Anders Damgaard Møller Schlünsen,&nbsp;David Høyrup Christiansen,&nbsp;Ulrich Fredberg,&nbsp;Peter Vedsted","doi":"10.1136/ihj-2020-000069","DOIUrl":"https://doi.org/10.1136/ihj-2020-000069","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of a 24-hour telephone access outpatient clinic (24-hour access clinic) in terms of healthcare utilisation and mortality in patients with five chronic conditions (chronic obstructive pulmonary disease, atrial fibrillation/flutter, congestive heart failure, inflammatory bowel disease and chronic liver disease).</p><p><strong>Methods and analysis: </strong>This was a registry-based controlled cohort study. The 24-hour access clinic was established at Silkeborg Regional Hospital in Central Denmark Region. The five other regional hospitals served as comparison hospitals. The 24-hour access clinic allowed patients with five chronic conditions with ongoing hospital outpatient follow-up to call the hospital outpatient clinic in case of an exacerbation. Outcomes were use of hospital admissions, length of stay (LOS), outpatient visits, contacts to general practice and all-cause mortality during 18 months of follow-up.</p><p><strong>Results: </strong>The study included 992 the 24-hour access patients and 3878 usual care patients. For the five conditions combined, the 24 hours access patients had fewer all-cause admissions (incidence rate ratio (IRR) 0.81, 95% Cl 0.71 to 0.92), general practice out-of-hours contacts (IRR 0.81, 95% C 0.71 to.92) and shorter LOS (IRR 0.71, 95% CI 0.57 to 0.88). The rate of all-cause outpatient visits tended to be higher (IRR 1.07, 95% CI 0.99 to 1.15). General practice daytime contacts were similar between the groups, and there was no significant difference in mortality.</p><p><strong>Conclusions: </strong>The results suggest that a 24-hour telephone access clinic may lead to enhanced integration of care measured as unplanned acute care substituted with planned outpatient care.</p>","PeriodicalId":73393,"journal":{"name":"Integrated healthcare journal","volume":"4 1","pages":"e000069"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4e/d9/ihj-2020-000069.PMC10241022.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9816603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Illuminating the importance of adding patient knowledge to continual improvement in healthcare.","authors":"Susanne Gustavsson,&nbsp;Carolina Bergerum,&nbsp;Agneta Patriksson,&nbsp;Susanne Tedsjö","doi":"10.1136/ihj-2021-000114","DOIUrl":"https://doi.org/10.1136/ihj-2021-000114","url":null,"abstract":"© Author(s) (or their employer(s)) 2022. Reuse permitted under CC BYNC. No commercial reuse. See rights and permissions. Published by BMJ. INTRODUCTION The importance of involving patients in quality improvement (QI) is becoming increasingly evident in healthcare. 2 To achieve this, various approaches, such as codesign and coproduction, are being introduced alongside different models and frameworks to improve the quality and safety of healthcare systems. Codesign describes a way of involving both patients and professionals in QI, focusing on the improvement of the experiences of healthcare services. Coproduction refers to the interdependent work of patients and professionals to design, create, develop, deliver, assess and improve the relationships and actions contributing to patient and public health. However, patent involvement and QI have, historically, mainly developed independently. The traditional way of working with improvements in healthcare has been for healthcare professionals to develop what they believe is best for the patients according to their professional knowledge only. Yet, to achieve, preserve and improve patient and population health, relationships between the various stakeholders, patients and the public included, some kind of joint action should be involved. There are synergies shown between professional knowledge, improvement knowledge and patient involvement in QI.Thus, an integration of patient and professional knowledge in QI can offer sustainability to the coproduction of value for patients. So, how can this synergy be displayed and understood by patients and professionals alike? Batalden and Stoltz introduced a framework (figure 1) in which the components of professional knowledge and improvement knowledge were linked to enable continual improvement of healthcare. Almost 20 years later, a model of healthcare service coproduction was proposed. In coproduction, patients and professionals work together by sharing their respective knowledge, skills, resources and responsibility. 8 Patients are arguably as much experts in determining healthcare outcomes as are professionals, although with expertise in terms of lived experiences of direct care and of the healthcare system, and knowledge of their symptoms, individual resources and of the context of their lives. In this viewpoint, we argue for the importance of adding patients’ experiential knowledge as an equally significant component of the original Framework for the Continual Improvement of Healthcare. We suggest a model for visualising how patient knowledge in healthcare QI may establish sustainable codesign and coproduction. If linked together, the three knowledge domains can enable continual and sustainable QI to better fit patient purposes and needs. The model may help healthcare organisations as well as patients and professionals to understand the importance of the integration.","PeriodicalId":73393,"journal":{"name":"Integrated healthcare journal","volume":"4 1","pages":"e000114"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/87/da/ihj-2021-000114.PMC10327452.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9816604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of a population-based integrated care model in reducing hospital activity: an interrupted time series analysis.","authors":"Mohammad Hussein Housam Mansour,&nbsp;Subhash Pokhrel,&nbsp;Maurice Birnbaum,&nbsp;Nana Anokye","doi":"10.1136/ihj-2021-000104","DOIUrl":"https://doi.org/10.1136/ihj-2021-000104","url":null,"abstract":"<p><strong>Objectives: </strong>First impact assessment analysis of an integrated care model (ICM) to reduce hospital activity in the London Borough of Hillingdon, UK.</p><p><strong>Methods: </strong>We evaluated a population-based ICM consisting of multiple interventions based on self-management, multidisciplinary teams, case management and discharge management. The sample included 331 330 registered Hillingdon residents (at the time of data extraction) between October 2018 and July 2020. Longitudinal data was extracted from the Whole Systems Integrated Care database. Interrupted time series Poisson and Negative binomial regressions were used to examine changes in non-elective hospital admissions (NEL admissions), accident and emergency visits (A&E) and length of stay (LoS) at the hospital. Multiple imputations were used to replace missing data. Subgroup analysis of various groups with and without long-term conditions (LTC) was also conducted using the same models.</p><p><strong>Results: </strong>In the whole registered population of Hillingdon at the time of data collection, gradual decline over time in NEL admissions (RR 0.91, 95% CI 0.90 to 0.92), A&E visits (RR 0.94, 95% CI 0.93 to 0.95) and LoS (RR 0.93, 95% CI 0.92 to 0.94) following an immediate increase during the first months of implementation in the three outcomes was observed. Subgroup analysis across different groups, including those with and without LTCs, showed similar effects. Sensitivity analysis did not show a notable change compared with the original analysis.</p><p><strong>Conclusion: </strong>The Hillingdon ICM showed effectiveness in reducing NEL admissions, A&E visits and LoS. However, further investigations and analyses could confirm the results of this study and rule out the potential effects of some confounding events, such as the emergence of COVID-19 pandemic.</p>","PeriodicalId":73393,"journal":{"name":"Integrated healthcare journal","volume":"4 1","pages":"e000104"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b9/03/ihj-2021-000104.PMC10327451.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9816606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing integrated-youth services virtually in British Columbia during the COVID-19 pandemic.","authors":"Marco Zenone,&nbsp;Al Raimundo,&nbsp;Suhail Nanji,&nbsp;Neha Uday,&nbsp;Karen Tee,&nbsp;Alayna Ewert,&nbsp;Warren Helfrich,&nbsp;Godwin Chan,&nbsp;Steve Mathias,&nbsp;Skye Barbic","doi":"10.1136/ihj-2021-000089","DOIUrl":"https://doi.org/10.1136/ihj-2021-000089","url":null,"abstract":"<p><strong>Objective: </strong>During the COVID-19 pandemic, Foundry responded to support youth across the province of British Columbia (BC), Canada, by creating a virtual platform to deliver integrated services to youth. In this paper, we report on the development of Foundry Virtual services, initial evaluation results and lessons learnt for others implementing virtual services.</p><p><strong>Methods and analysis: </strong>In April 2020, Foundry launched its virtual services, providing young people and their caregivers from across BC with drop-in counselling services via chat, voice or video calls. Foundry consulted with youth and caregivers to implement, improve and add services. Using Foundry's quality improvement data tool, we document service utilisation, the demographic profile of young people accessing virtual services, and how young people rate the quality of services accessed.</p><p><strong>Findings: </strong>Since launching, 3846 unique youth accessed Foundry Virtual services over 8899 visits, totalling 11 943 services accessed. The predominant services accessed were walk in counselling (32.5%), mental health and substance use services (31.4%), youth peer support (17.2%) and group services (7.3%). Over 95% of youth reported that they would recommend virtual services to a friend.</p><p><strong>Conclusion: </strong>In response to our early findings, we provide three recommendations for other implementers. First, engage the audience in which you intend to serve at every phase of the project. Second, invest in the needs of staff to ensure they are prepared and supported to deliver services. Last, imbed a learning health system to allow for the resources culture of continuous learning improvement that allows for rapid course adjustments and shared learning opportunities.</p>","PeriodicalId":73393,"journal":{"name":"Integrated healthcare journal","volume":"4 1","pages":"e000089"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7b/4a/ihj-2021-000089.PMC10241026.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9816609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding potentially avoidable hospitalisations in a rural Australian setting from the perspectives of patients and health professionals: a qualitative study and logic model.","authors":"Kristen Glenister,&nbsp;Tessa Archbold,&nbsp;Anna Moran,&nbsp;David Kidd,&nbsp;Sue Wilson,&nbsp;Rebecca Disler","doi":"10.1136/ihj-2021-000124","DOIUrl":"https://doi.org/10.1136/ihj-2021-000124","url":null,"abstract":"<p><strong>Background: </strong>Potentially avoidable hospitalisations (PAHs) are proxy measures of effective primary care at a population level. PAHs are higher in rural and disadvantaged areas. This qualitative study sought a deeper understanding of PAHs for chronic health conditions in a rural context from the perspectives of patients and health professionals, and aimed to develop a logic model for rural health services to identify intervention targets.</p><p><strong>Methods: </strong>Patients with chronic obstructive pulmonary disease, congestive cardiac failure or type 2 diabetes, admitted to a rural hospital in Australia and local health professionals were invited to participate in interviews in late 2019. Semistructured interviews were recorded, transcribed verbatim and thematically analysed. Themes were mapped against a programme logic model developed in a similar study.</p><p><strong>Results: </strong>patients and 16 health professionals participated. The logic model encompassed patient level (knowledge, skills, health status), provider level (workforce availability, attributes) and system level (clinical pathways) contexts. These contexts influenced key mechanisms of relationships, continuity of care and capacity to offer services. Outcomes included responsive and timely access to care, improved clinical outcomes and resource use. Themes that did not readily map to the logic model included socioeconomic disadvantage and healthcare costs, which influenced affordability and equity of access.</p><p><strong>Conclusion: </strong>Patients' complex health and social circumstance, health service access and unclear care pathways were strong themes associated with PAH in this rural context. Patient, provider and system contexts influencing key mechanisms and outcomes need to be understood when designing solutions to address PAHs in rural settings. Ideally, interventions should address the cost of healthcare alongside interventions to enhance relationships, continuity of care and capacity to offer services.</p>","PeriodicalId":73393,"journal":{"name":"Integrated healthcare journal","volume":"4 1","pages":"e000124"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/89/71/ihj-2021-000124.PMC10241033.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10192788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolving role of novel COVID-19 Medicine Delivery Units.","authors":"Alice Packham,&nbsp;Niamh Spence,&nbsp;Anna Goodman","doi":"10.1136/ihj-2022-000135","DOIUrl":"https://doi.org/10.1136/ihj-2022-000135","url":null,"abstract":"The COMET-ICE trial showed a relative risk reduction of 85% (p=0.0002) in rates and hospitalisation and death compared with placebo.3 Overall, sotrovimab has an excellent tolerability and safety profile with minimal drug interactions, making it suitable for most patients. Severely immunocompromised patients are unlikely to have a robust immune response either to COVID-19 infection or previous COVID-19 vaccination.15 Variation between immunocompromised subgroups has been noted, with the lowest levels of vaccine efficacy in organ or stem cell transplant recipients.16 Immunocompromised patients potentially have much to gain from sotrovimab and other antivirals. Early in vitro assays suggest the same may occur to sotrovimab, with far lower impact on the increasingly dominant Omicron variant BA.2.17 The United States Food and Drug Administration (FDA) no longer recommends sotrovimab in any US region due to the increased proportion of cases caused by BA.2.18 It remains in use in the UK at present. According to the clinical commissioning guidelines, sotrovimab can be used in pregnancy, and remdesivir requires a risk–benefit clinical assessment.","PeriodicalId":73393,"journal":{"name":"Integrated healthcare journal","volume":"4 1","pages":"e000135"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/72/a9/ihj-2022-000135.PMC10241034.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10174329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated primary care behavioural health in a regional network of FQHC agencies during COVID-19.","authors":"Travis A Cos,&nbsp;Natalie Levkovich,&nbsp;Christopher W Tjoa,&nbsp;Shakira K Williams,&nbsp;Carol S Larach","doi":"10.1136/ihj-2022-000125","DOIUrl":"https://doi.org/10.1136/ihj-2022-000125","url":null,"abstract":"<p><strong>Objectives: </strong>(1) Examine the ability to sustain integrated primary care behavioural health (eg, colocation, communication and coordination) in 40 community health centres, during the COVID-19 pandemic and (2) review adaptations and challenges to provide integrated behavioural health via telehealth.</p><p><strong>Methods and analysis: </strong>This qualitative investigation assessed 55 behavioural health consultants (BHCs), via semistructured interviews, spanning 40 practice sites and 10 organisations, on their adjustment to telehealth delivery, modified practice workflows and challenges of maintaining integration while displaced by the pandemic. Assessment of the level of integrated care was also conducted with available semistructured tools.</p><p><strong>Results: </strong>The results highlight rapid service adjustment, positive patient and provider satisfaction, increased but lowered ratings of remote BHC integration and collaboration with the primary care teams and reduced behavioural health screening, compared with prepandemic levels. This investigation also highlights the co-occurring importance of racial disparities and injustice in patient care. In several settings, BHCs had a significant support role for staff self-care.</p><p><strong>Conclusion: </strong>The COVID-19 pandemic, and its subsequent shelter-in-place mandates and telehealth care provision, has altered standard integrated behavioural health practice, yet harnessed the accessible, generalist and team-based spirit to meet the increasing behavioural health needs in this community.</p>","PeriodicalId":73393,"journal":{"name":"Integrated healthcare journal","volume":"4 1","pages":"e000125"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4a/d2/ihj-2022-000125.PMC10327467.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9814047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating healthcare services for people experiencing homelessness in Australia: key issues and research principles.","authors":"Brendan Clifford,&nbsp;Lisa Wood,&nbsp;Shannen Vallesi,&nbsp;Stephanie Macfarlane,&nbsp;Jane Currie,&nbsp;Fiona Haigh,&nbsp;Katherine Gill,&nbsp;Andrew Wilson,&nbsp;Patrick Harris","doi":"10.1136/ihj-2020-000065","DOIUrl":"https://doi.org/10.1136/ihj-2020-000065","url":null,"abstract":"Improving health outcomes requires understanding the complex role of structural determinants of homelessness, such as the availability of secure housing and employment, gender equality, racism, in addition to the funding and structure of health and social services.3 The requirement for health service responses that are tailored to people experiencing homelessness has been highlighted by the COVID-19 pandemic. People experiencing homelessness have few resources with which to support prevention measures from COVID-19, such as accommodation that enables social distancing and self-isolation or hygiene facilities, compounding the risk from higher rates of diseases such as chronic respiratory conditions.4 These factors require an integrated service response from health and housing in order to successfully protect health and reduce transmission risk. Individuals who can provide an address and people who do not appear ‘typically homeless’ may not be asked about their housing status.6 Better recognition of homelessness in healthcare services requires the development of screening tools and processes, as well as systems that support healthcare workers in understanding and responding to homelessness.7 Though issues exist with the use of administrative health service data for research purposes (eg, ‘no fixed address’ being shown to be a poor indicator of homelessness),6 there is potential for such data to better characterise the composition and the needs of this population. In Australia, implementing the healthcare component of such wraparound support is complicated by a complex health system with differing state, federal and ‘out-of-pocket’ funding mechanisms and a blended public and private service delivery model.","PeriodicalId":73393,"journal":{"name":"Integrated healthcare journal","volume":"4 1","pages":"e000065"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f6/9b/ihj-2020-000065.PMC10241025.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9816607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Online networks facilitating multidisciplinary healthcare: a novel strategy to curb COVID-19.","authors":"Henrieke Prins,&nbsp;Ineke Knijp,&nbsp;Gonneke Hermanides,&nbsp;Marco Blanker,&nbsp;Casper Rokx","doi":"10.1136/ihj-2021-000079","DOIUrl":"https://doi.org/10.1136/ihj-2021-000079","url":null,"abstract":"<p><strong>Objectives: </strong>Global spread of COVID-19 at an unprecedented speed has heavily strained healthcare systems worldwide, and reliable alternatives to analogue healthcare are urgently needed.</p><p><strong>Methods: </strong>During the first COVID-19 wave in the Netherlands, we launched six regional online networks and analysed the activity and content in a qualitative mixed-methods manner.</p><p><strong>Results: </strong>We observed continued activity and collaboration on the platform between healthcare professionals at the different levels of care.</p><p><strong>Conclusion: </strong>The networks described here were launched successfully and have the potential to optimise the COVID-19 response.</p>","PeriodicalId":73393,"journal":{"name":"Integrated healthcare journal","volume":"4 1","pages":"e000079"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/37/c7/ihj-2021-000079.PMC10327465.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10174327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interdisciplinary patient-centred poststroke care in Follow-up After Stroke, Screening and Treatment (FASST) clinic model: a proof-of-concept pilot study.","authors":"Min Sun Kim,&nbsp;Sean V Cleymaet,&nbsp;Seung Kim,&nbsp;Jennifer Andres,&nbsp;Charles Ruchalski,&nbsp;Yongwoo Kim,&nbsp;S Ausim Azizi,&nbsp;Anjail Z Sharrief,&nbsp;Imama A Naqvi","doi":"10.1136/ihj-2021-000118","DOIUrl":"https://doi.org/10.1136/ihj-2021-000118","url":null,"abstract":"<p><strong>Background: </strong>Although secondary stroke prevention is important, the optimal outpatient model that improves risk factor control and decreases post-stroke complications effectively has not been established. We created Follow-up After Stroke, Screening and Treatment (FASST), an interdisciplinary clinic involving stroke physicians and pharmacists to address poststroke complications and secondary stroke prevention systemically. We present our approach to assess its proof-of-concept in our pilot study.</p><p><strong>Methods: </strong>We included the patients attending FASST clinic after their hospital discharge. We used validated survey screens to assess for complications: depression, anxiety, sleep disorders, cognitive impairment, disability, social support, quality of life and functional status. Data were collected including risk factors, complication screening results and outcome scores. Clinical pharmacists assessed risk factor control and health-related behaviours for modification.</p><p><strong>Results: </strong>Of the 25 patients enrolled in the interdisciplinary clinic, all had comorbid hyperlipidaemia and hypertension, and 44% had diabetes mellitus. About one-third needed medication changes for risk factor control. On screening, 16% of patients were found to have depression, 12% had anxiety and 20% had sleep apnoea. These patients were either managed in the clinic or were referred to relevant subspeciality clinics. The status of risk factor control was assessed in all patients, and 32% had medications adjustments.</p><p><strong>Conclusion: </strong>Our preliminary data found that FASST clinic model is feasible and potentially useful. It represents an integrated approach to post-stroke care, with pharmacist collaboration to improve risk factor control, while assessing for poststroke complications. Further study is needed to improve health outcomes through integrated poststroke care.</p>","PeriodicalId":73393,"journal":{"name":"Integrated healthcare journal","volume":"4 1","pages":"e000118"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6a/2a/ihj-2021-000118.PMC10327447.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9816608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}