MORe PREcISE: Longitudinal patient reported outcome measures in stroke at 3 and 6 months.

Corrigan, Amber E., Verstraete, Marie A. G., Carter, Ben, Smith, Alexander, Pennington, Anna and Hewitt, Jonathan ORCID: https://orcid.org/0000-0002-7924-1792 2024. MORe PREcISE: Longitudinal patient reported outcome measures in stroke at 3 and 6 months. Journal of Stroke & Cerebrovascular Diseases 33 (12) , 108023. 10.1016/j.jstrokecerebrovasdis.2024.108023 Item availability restricted.

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Abstract

Background and Purpose Post-stroke morbidity is common, but little is known about the burden on patients’ lives from their own perspective. Understanding morbidity from the point of view of the patient may support targeted intervention in post-stroke recovery. This study used a stroke specific Patient Reported Outcome Measure (PROM) containing Mental health (MH) and Physical Health (PH) domains and 5 stroke specific questions. We aimed to consider trends over a 6-month period and further assess the association between the MH and PH measures and common clinical measures. Methods A multicenter prospective cohort study was conducted at 19 hospital sites across England and Wales. Patients were enrolled from August 2018 to September 2019. Clinical measures and PROMs were assessed at three timepoints: acutely following the index stroke, at 3 and 6-months post-stroke. Clinical measures and PROMs were assessed in each of these points. Results Physical health PROM domains show significant gradual improvement across the study period (χ2 42.6312, p<0.0001), whereas cognitive function domains (χ2 3.7849, p<0.875) did not echo this trend. All clinical measures (GAD-7, PHQ9, MoCA, MRS) were associated with poorer PROM MH outcomes, (aMD -4.4, CI -0.59, -0.29, p≤0.001, aMD -0.45, CI -0.59, -0.32, p= <0.001, aMD 0.75, CI 0.56, 0.95, aMD -1.91, CI -2.41, -1.47, p≤0.001). Clinical measures of disability, as per the MRS, are associated with poor PROM PH scores (aMD -0.57, 95% CI -0.94, -0.20, p=0.003). Conclusions This research indicates there is unmet cognitive burden in stroke survivors. PROMs may be able to measure unmet more discretely than common clinical tools that are used post-stroke. Further research and guidance on how to integrate PROMs into current clinical frameworks is essential.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Additional Information:	License information from Publisher: LICENSE 1: URL: http://creativecommons.org/licenses/by/4.0/, Start Date: 2024-09-21
Publisher:	Elsevier
ISSN:	1052-3057
Date of First Compliant Deposit:	23 September 2024
Date of Acceptance:	17 September 2024
Last Modified:	11 Nov 2024 14:45
URI:	https://orca.cardiff.ac.uk/id/eprint/172336

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