title: Canadian Stroke Best Practice Recommendations: Mood, Cognition and Fatigue Following Stroke practice guidelines, update 2015.
abstract: Every year, approximately 62 000 people with stroke and transient ischemic attack are treated in Canadian hospitals, and the evidence suggests one-third or more will experience vascular-cognitive impairment, and/or intractable fatigue, either alone or in combination. The 2015 update of the Canadian Stroke Best Practice Recommendations: Mood, Cognition and Fatigue Module guideline is a comprehensive summary of current evidence-based recommendations for clinicians in a range of settings, who provide care to patients following stroke. The three consequences of stroke that are the focus of the this guideline (poststroke depression, vascular cognitive impairment, and fatigue) have high incidence rates and significant impact on the lives of people who have had a stroke, impede recovery, and result in worse long-term outcomes. Significant practice variations and gaps in the research evidence have been reported for initial screening and in-depth assessment of stroke patients for these conditions. Also of concern, an increased number of family members and informal caregivers may also experience depressive symptoms in the poststroke recovery phase which further impact patient recovery. These factors emphasize the need for a system of care that ensures screening occurs as a standard and consistent component of clinical practice across settings as stroke patients transition from acute care to active rehabilitation and reintegration into their community. Additionally, building system capacity to ensure access to appropriate specialists for treatment and ongoing management of stroke survivors with these conditions is another great challenge.
authors.affiliation: Departments of Psychiatry, Psychology, & Neuroscience, Dalhousie University, Halifax, Canada.
authors.forename: Gail A
authors.initials: GA
authors.lastname: Eskes
authors.affiliation: Sunnybrook Health Sciences Centre, Toronto, Canada.|University of Toronto, Toronto, Canada.
authors.forename: Krista L
authors.initials: KL
authors.lastname: Lanctôt
authors.affiliation: Sunnybrook Health Sciences Centre, Toronto, Canada.|University of Toronto, Toronto, Canada.
authors.forename: Nathan
authors.initials: N
authors.lastname: Herrmann
authors.affiliation: University of Toronto, Toronto, Canada.|Heart and Stroke Foundation, Ottawa, Canada.
authors.forename: Patrice
authors.initials: P
authors.lastname: Lindsay
authors.affiliation: University of Toronto, Toronto, Canada.|Toronto Rehabilitation Institute, University Health Network, Toronto, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Bayley
authors.affiliation: Moncton Hospital/Miramichi Regional Hospital, Miramichi, Canada.
authors.forename: Laurie
authors.initials: L
authors.lastname: Bouvier
authors.affiliation: Department of Occupational Science & Occupational Therapy, & Graduate Department of Rehabilitation Sciences, University of Toronto, Toronto, Canada.
authors.forename: Deirdre
authors.initials: D
authors.lastname: Dawson
authors.affiliation: Riverview Health Centre, Winnipeg, Canada.
authors.forename: Sandra
authors.initials: S
authors.lastname: Egi
authors.affiliation: Department of Psychology, Glenrose Hospital Stroke Program, Edmonton, Canada.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Gilchrist
authors.affiliation: Faculty of Nursing, University of Calgary, Calgary, Canada.
authors.forename: Theresa
authors.initials: T
authors.lastname: Green
authors.affiliation: Department of Neurology, Faculty of Medicine, Dalhousie University, Halifax, Canada.
authors.forename: Gord
authors.initials: G
authors.lastname: Gubitz
authors.affiliation: Department of Clinical Neurosciences, Calgary Stroke Program, University of Calgary, Hotchkiss Brain Institute, Calgary, Canada.
authors.forename: Michael D
authors.identifier: http://orcid.org/0000-0002-6269-1543
authors.initials: MD
authors.lastname: Hill
authors.affiliation: Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.
authors.forename: Tammy
authors.initials: T
authors.lastname: Hopper
authors.affiliation: Stroke Department, Richardson Hospital and Montreal University Health Center, Royal Victoria Hospital, Montreal, Canada.
authors.forename: Aisha
authors.initials: A
authors.lastname: Khan
authors.affiliation: Stroke Program Department, Queen Elizabeth II Health Sciences Centre, Capital District Health Authority, Halifax, Canada.
authors.forename: Andrea
authors.initials: A
authors.lastname: King
authors.affiliation: Pediatrics and Clinical Neurosciences, Faculty of Medicine, University of Calgary, Alberta Children's Hospital Research Institute, Calgary, Canada.
authors.forename: Adam
authors.initials: A
authors.lastname: Kirton
authors.affiliation: Stroke Program Department, Queen Elizabeth II Health Sciences Centre, Capital District Health Authority, Halifax, Canada.
authors.forename: Paige
authors.initials: P
authors.lastname: Moorhouse
authors.affiliation: Department of Clinical Neurosciences, Calgary Stroke Program, University of Calgary, Hotchkiss Brain Institute, Calgary, Canada.
authors.forename: Eric E
authors.initials: EE
authors.lastname: Smith
authors.affiliation: Departments of Psychiatry, Psychology, & Neuroscience, Dalhousie University, Halifax, Canada.
authors.forename: Janet
authors.initials: J
authors.lastname: Green
authors.affiliation: Western University, London, Canada.
authors.forename: Norine
authors.initials: N
authors.lastname: Foley
authors.affiliation: Western University, London, Canada.
authors.forename: Katherine
authors.initials: K
authors.lastname: Salter
authors.affiliation: Sunnybrook Health Sciences Centre, Toronto, Canada.|University of Toronto, Toronto, Canada.
authors.forename: Richard H
authors.initials: RH
authors.lastname: Swartz
mesh_terms: D002170:Canada / Q000453:epidemiology; D003072:Cognition Disorders / Q000209:etiology*; D005221:Fatigue / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D019964:Mood Disorders / Q000209:etiology*; D017410:Practice Guidelines as Topic; D016730:Program Development / Q000592:standards; D020521:Stroke / Q000150:complications / Q000453:epidemiology / Q000628:therapy*
keywords: depression; fatigue; guidelines; stroke; transient ischemic attack; vascular cognitive impairment