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Please use this identifier to cite or link to this item: http://hdl.handle.net/1860/3605

Title: Patient ­adherence to Stroke Reduction Guidelines
Authors: Tao, Lei
Keywords: Public Health;Stroke;Patient Compliance
Issue Date: 26-Sep-2011
Abstract: Background: Patient-adherence is critical in the health care system. Adherence can bridge the difference between patient’s needs and the health care system’s capacity. Strokes are the third leading cause of death and the leading cause of long-term disabilities costing $68.9 billion in the US in 2009. Non-adherence wastes resources through unnecessary hospital visits and tests. Adherence is a preventative measure that can reduce disease burden by ensuring patients get the most benefits possible from guidelines and treatment plans. Objectives: Assess the effectiveness of counseling at the stroke screenings and determine factors that may be associated with patient adherence to stroke guidelines. This would help better serve the community in gaining benefits by receiving education and resources on strokes more efficiently. Methods: Factors associated with adherence and the effectiveness of the screening was determined with an intervention study. Nursing students conducted surveys and checked for cardiac risks at four screenings in Philadelphia and New Jersey. The survey assessed medical, demographic, and lifestyle risks. The educational session at the screenings included counseling vii and materials on stroke reduction and awareness. 113 people were assessed at the screenings. 65 people agreed and 42 refused follow-up. 6 had missing follow-up information. 39 people were successfully contacted 8 weeks after the screening. 27 individuals met the patient-adherence definition of following majority of the guidelines established. Backward selection was used to determine the multivariate logistic regression model for patient-adherence prediction and analysis. Confounders such as gender, counseling effects, education, and age were assessed. Wilcoxon Signed ranked test determined if there was a difference in stroke concern prior and after counseling. Results: Greater concerns of having a stroke and educational counseling were predictive of higher rates of adherence. Educational counseling was borderline significant with a p-value of 0.056. Concern levels were significant with a p-value of 0.032. Stroke counseling consistently showed reduced stroke concerns across all screenings. Conclusions: Counseling has a concern reducing effect. Stroke concern is directly related to patient adherence. The odds of 1.641 shows a 64.1% increased probability of patient adherence occurring compared to non-adherence for each unit increase in the stroke concern.
URI: http://hdl.handle.net/1860/3605
Appears in Collections:Health Sciences Theses and Dissertations

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