Background: After a stroke, a person has an increased risk of recurrent strokes. Effective secondary prevention can provide significant gains in the form of reduced disability and mortality. While considerable efforts have been made to provide high quality acute treatment of stroke, there has been less focus on the follow-up in general practice after the stroke. One strategy for the implementation of high quality, evidence-based treatment is the development and distribution of clinical guidelines. However, from similar fields of practice, we know that guidelines are often not adhered to. The purpose of this study was to investigate to what degree patients who have suffered a stroke are followed up in general practice, if recommendations in the national guidelines are followed, and if patients achieve the treatment goals recommended in the guidelines.
Methods: The study included patients with cerebral infarction identified by the ICD-10 discharge diagnoses I63.0 trough I63.9 in two Norwegian local hospitals. In total 51 patients participated. They were listed with general practitioners in 18 different clinics. The material consists of the general practitioners' (GPs') medical records for these patients in the first year of follow-up; in total 381 consultations.
Results: Of the 381 consultations during the first year of follow-up, 71 (19%) had stroke as the main topic. The blood pressure (BP) target value < 140/90 mmHg was reached by 24 patients (47%). The low density lipoprotein (LDL) cholesterol target value < 2.0 mmol/L was reached by 14 (27%) of the 51 patients. In total six patients (12%) got advice on physical activity and three (6%) received dietary advice. No advice about alcohol consumption was recorded.
Conclusions: The findings support earlier claims that the development and distribution of guidelines alone is not enough to implement a certain practice. Despite being a serious condition, stroke gets limited attention in the first year of follow-up in general practice. This can be explained by the complexity of general practice, where even a serious condition loses the competition for attention to other apparently equally important issues.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6263549 | PMC |
| http://dx.doi.org/10.1186/s12875-018-0872-9 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Robust text-dependent speaker verification system using gender aware Siamese-Triplet Deep Neural Network.
Network
December 2024
Department of Electronics and Communication Engineering, Dronacharya Group of Institutions, Greater Noida, UP, India.
Speaker verification in text-dependent scenarios is critical for high-security applications but faces challenges such as voice quality variations, linguistic diversity, and gender-related pitch differences, which affect authentication accuracy. This paper introduces a Gender-Aware Siamese-Triplet Network-Deep Neural Network (ST-DNN) architecture to address these challenges. The Gender-Aware Network utilizes Convolutional 2D layers with ReLU activation for initial feature extraction, followed by multi-fusion dense skip connections and batch normalization to integrate features across different depths, enhancing discrimination between male and female speakers.
View Article and Find Full Text PDFCross-Sectoral Comparisons of Process Quality Indicators of Health Care Across Residential Regions Using Restricted Mean Survival Time.
Med Care
November 2024
Institute of Clinical Biometrics, Center for Medical Data Science, Medical University of Vienna, Vienna, Austria.
Background: Practice guidelines recommend patient management based on scientific evidence. Quality indicators gauge adherence to such recommendations and assess health care quality. They are usually defined as adverse event rates, which may not fully capture guideline adherence over time.
View Article and Find Full Text PDFHarnessing Raman spectroscopy and multimodal imaging of cartilage for osteoarthritis diagnosis.
Sci Rep
December 2024
School of Chemistry, Faculty of Engineering and Physical Sciences, University of Southampton, Life Sciences Building 85, University Road, Highfield, Southampton, SO17 1BJ, UK.
Osteoarthritis (OA) is a complex disease of cartilage characterised by joint pain, functional limitation, and reduced quality of life with affected joint movement leading to pain and limited mobility. Current methods to diagnose OA are predominantly limited to X-ray, MRI and invasive joint fluid analysis, all of which lack chemical or molecular specificity and are limited to detection of the disease at later stages. A rapid minimally invasive and non-destructive approach to disease diagnosis is a critical unmet need.
View Article and Find Full Text PDFPatients with cirrhosis have high systemic inflammation (TNFα, CRP, and IL-6) that is associated with poor outcomes. These biomarkers need continuous non-invasive monitoring, which is difficult with blood. We studied the AWARE sweat-sensor to measure these in passively expressed sweat in healthy people (N = 12) and cirrhosis (N = 32, 10 outpatients/22 inpatients) for 3 days.
View Article and Find Full Text PDFDevelopment of respiratory motion-resolved hepatobiliary phase cine-magnetic resonance imaging for stereotactic body radiotherapy in liver tumor.
Sci Rep
December 2024
Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan.
Cine-magnetic resonance imaging (MRI) has been used to track respiratory-induced motion of the liver and tumor and assist in the accurate delineation of tumor volume. Recent developments in compressed sensitivity encoding (SENSE; CS) have accelerated temporal resolution while maintaining contrast resolution. This study aimed to develop and assess hepatobiliary phase (HBP) cine-MRI scans using CS.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!