A multidisciplinary stroke clinic for outpatient care of veterans with cerebrovascular disease

Arlene A. Schmid, John R. Kapoor, Edward J. Miech, Deborah Kuehn, Mary I. Dallas, Robert D. Kerns, Albert C. Lo, John Concato, Michael S. Phipps, Cody D. Couch, Eileen Moran, Linda S. Williams, Layne A. Goble, Dawn M. Bravata

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Background: Managing cerebrovascular risk factors is complex and difficult. The objective of this program evaluation was to assess the effectiveness of an outpatient Multidisciplinary Stroke Clinic model for the clinical management of veterans with cerebrovascular disease or cerebrovascular risk factors.

Methods: The Multidisciplinary Stroke Clinic provided care to veterans with cerebrovascular disease during a one-half day clinic visit with interdisciplinary evaluations and feedback from nursing, health psychology, rehabilitation medicine, internal medicine, and neurology. We conducted a program evaluation of the clinic by assessing clinical care outcomes, patient satisfaction, provider satisfaction, and costs.

Results: We evaluated the care and outcomes of the first consecutive 162 patients who were cared for in the clinic. Patients had as many as six clinic visits. Systolic and diastolic blood pressure decreased: 137.2 ± 22.0 mm Hg versus 128.6 ± 19.8 mm Hg, P = 0.007 and 77.9 ± 14.8 mm Hg versus 72.0 ± 10.2 mm Hg, P = 0.004, respectively as did low-density lipoprotein (LDL)- cholesterol (101.9 ± 23.1 mg/dL versus 80.6 ± 25.0 mg/dL, P = 0.001). All patients had at least one major change recommended in their care management. Both patients and providers reported high satisfaction levels with the clinic. Veterans with stroke who were cared for in the clinic had similar or lower costs than veterans with stroke who were cared for elsewhere.

Conclusion: A Multidisciplinary Stroke Clinic model provides incremental improvement in quality of care for complex patients with cerebrovascular disease at costs that are comparable to usual post-stroke care.

Original languageEnglish (US)
Pages (from-to)111-118
Number of pages8
JournalJournal of Multidisciplinary Healthcare
Volume4
DOIs
StatePublished - Apr 28 2011

Keywords

  • Blood pressure management
  • Clinical management of stroke
  • Clinical outcome
  • Cost

ASJC Scopus subject areas

  • Nursing(all)
  • Medicine(all)

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  • Cite this

    Schmid, A. A., Kapoor, J. R., Miech, E. J., Kuehn, D., Dallas, M. I., Kerns, R. D., Lo, A. C., Concato, J., Phipps, M. S., Couch, C. D., Moran, E., Williams, L. S., Goble, L. A., & Bravata, D. M. (2011). A multidisciplinary stroke clinic for outpatient care of veterans with cerebrovascular disease. Journal of Multidisciplinary Healthcare, 4, 111-118. https://doi.org/10.2147/JMDH.S17154