Abstract WP468: Follow Up After Stroke, Screening and Treatment Clinic: Advancing Post-Stroke Care

Abstract

Objective: To assess feasibility and replicability of a multidisciplinary, specialized clinic in optimization of secondary stroke prevention and stroke related complications. Background: Recommendations exist for secondary stroke prevention, but it is unclear which outpatient model of care optimizes vascular risk factor control and decreases post-stroke complications most effectively. Designed after the Stroke Transitions, Education, and Prevention clinic in Houston, TX, the Follow up After Stroke, Screening and Treatment (FASST) clinic is an integrated, multidisciplinary, specialized clinic designed to optimize secondary stroke prevention. It provides post discharge stroke education and medication adherence counseling by Pharmacists, as well risk factor and complications management by Vascular Neurologists. Validated patient reported surveys screen for complications: depression, anxiety, sleep disorders, cognitive impairment, disability, social support, quality of life and functional status. Our approach and the characteristics of patients enrolled in the clinic is described. Methods: Patients attending one FASST clinic visit are included. Institutional Board Review approved consent is obtained. Demographic and clinical data are recorded including risk factors, surveys and outcome scores. Data is entered in Redcap and analyzed through the Statistical Analysis Software (SAS) program. Results: Of the 25 patients enrolled in the clinic, 83.3% are African American. A high prevalence of hyperlipidemia (100%) and hypertension (100%) exists, with 44% of patients having concomitant diabetes mellitus. Overall 26.7% screened positive for depression with PHQ-9, and 20% screened positive for anxiety with GAD-7. These patients were started on medications and referred for psychotherapy. Abnormal ESS scores were noted in 31.3% and directed for sleep apnea evaluation. Eighteen medical and pharmacy trainees rotated through the clinic. Conclusion: The FASST clinic represents a reproducible model for an integrated approach to post-stroke care. Adapted to academic centers across the country, a collaborative network would provide best practices, and measure patient reported outcomes to optimize stroke care.