RESEARCH
IMPLEMENTATION
OF A STROKE RISK REDUCTION PROGRAM IN
A NEUROLOGY PRIVATE PRACTICE
(Presented
at the Annual Scientific Meeting of
the American Association for
Cardiovascular and Pulmonary
Rehabilitation, Phoenix, Arizona,
September 1999)
W.G. Widener, E.F. Lafranchise, R.D.
Salmon, B.S. Mitchell, L.I. Levinrad,
E. Blaschko, and N.F. Gordon,
Neurological Institute of Savannah and
INTERxVENTUSA, Inc., Savannah, GA
Summary
Despite
recognition of modifiable risk factors
for a first or recurrent stroke and
the availability
of well-known treatments, sub-optimal
control of risk factors continues to contribute
to more than 700,000 strokes in the
United States each year.
We have developed
and implemented an innovative
physician supervised, nurse case
managed stroke
risk reduction program in a private
practice neurology clinic (the
Neurological Institute
of Savannah).
The program, called the
INTERxVENTUSA Stroke Risk Reduction
Program,
targets patients who have previously
suffered a stroke or TIA, and those
with carotid
artery disease.
It incorporates all key
components of a comprehensive stroke
risk reduction
program, including:
(1) prospective stroke risk appraisal;
(2) medical
evaluation
and risk factor assessment;
(3) risk
factor goal setting;
(4) treatment
plan formulation;
(5) treatment plan implementation;
(6)
long-term follow-up and re-evaluation,
with revision of treatment plan;
(7)
compliance tracking; and
(8) outcomes
assessment.
Program staff are guided by a
computerized patient management and tracking
system which incorporates algorithms
based on national guidelines.
Lifestyle interventions
are administered using
scientifically-based behavior
modification strategies.
Medication
changes are coordinated through the
patient’s primary care physician and
other
relevant physicians.
Our initial experiences support
the feasibility of administering a
comprehensive stroke risk reduction
program in a private practice
neurology setting.
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