An individualized coaching program for patients with acute ischemic stroke: Feasibility study.
OBJECTIVE
An individualized stroke care program was developed to match patients' education with their needs regarding stroke knowledge, secondary prevention and rehabilitation. Our purpose was to assess feasibility of in-hospital and post-discharge, personalized stroke coaching service.


METHODS
Acute ischemic stroke patients enrolled in ASTRAL-B stroke registry (Sint-Lucashospital, Bruges Belgium) with: (a) hospitalization between 12/2014-12/2015, (b) hospital-to-home discharge, and (c) without cognitive decline, were selected. The stroke coach contacted patients individually twice during hospitalization (2×20min) and post-discharge via phone calls using the standardized WSO Post-Strokechecklist. Risk factor management, review of therapy and clinical evolution were discussed. Participants were contacted at 2 weeks, followed by repeat calls if necessary and ambulatory with the vascular neurologist at 1, 3, 6 and 12 months.


RESULTS
Of all 255 patients meeting the inclusion criteria, 152 (59.7%) received individualized education during hospitalization by the stroke coach. Median age of our population was 74 years and median NIHSS 5. Majority of patients had at least two cardiovascular risk factors. Patients were not coached because of palliative care/decease (10%), unfavorable life expectancy (2%), dementia (8.5%) and lack of time due to short hospitalization (22%). A quarter of all patients were contacted at least once by phone, 12% were contacted at least twice after discharge. At three months, low stroke recurrence (5%) and mortality rates (4%) were identified, probably linked to improved adherence.


CONCLUSIONS
We demonstrated feasibility of an individualized coaching service executed by well-trained stroke nurse. Future research will focus on developing an online portal delivering post-discharge services to patients and caregivers.
Department of Neurology, Sint-Lucashospital, Bruges, Belgium; NeuroVascular Reference Center, Antwerp University Hospital, Edegem, Belgium. Electronic address: peter.vanacker@stlucas.be.
P
P
Vanacker
Department of Neurology, Sint-Lucashospital, Bruges, Belgium.
D
D
Standaert
Department of Neurology, Sint-Lucashospital, Bruges, Belgium.
N
N
Libbrecht
Department of Neurology, Sint-Lucashospital, Bruges, Belgium.
I
I
Vansteenkiste
Medical director, Sint-Lucashospital, Bruges, Belgium.
D
D
Bernard
NeuroVascular Reference Center, Antwerp University Hospital, Edegem, Belgium.
L
L
Yperzeele
Department of Neurology, Sint-Janhospital, Bruges, Belgium.
G
G
Vanhooren
D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium; D002545:Brain Ischemia / Q000517:prevention & control*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D010865:Pilot Projects; D055502:Secondary Prevention / Q000379:methods*; D020521:Stroke / Q000517:prevention & control*; D016896:Treatment Outcome
Cerebral infarction; Coaching; Education