Highlights
- •Poststroke depression is often unrecognized in normal clinical routines.
- •There is a risk that depression in patients with a mild stroke may not be detected.
- •Early depressive symptoms were associated with depressive symptoms at 18 months.
- •Prescheduled follow-ups improve the compliance with depression screening.
Abstract
Objectives
To investigate the extent to which the mood of stroke patients is assessed and what
kind of assessment methods are used in routine clinical practice, and whether prescheduled
follow-ups can improve the detection of depression, particularly when this practice
is blended with better education for health care professionals in assessing and detecting
depression.
Design
Before–after trial with an 18-month follow-up and a review of medical records.
Setting
Acute care hospital, community.
Participants
Consecutive acute stroke patients (N=398) were screened. Patients lived in a health
care district with a population of 132,000. The screening took place in the first
half of 2010 and then again, after the implementation of the follow-up system, in
the first half of 2012. After exclusion of patients too severely ill to be interviewed,
there were n=105 patients in the 2010 sample and n=112 patients in the 2012 sample.
Intervention
Implementation of a follow-up path for all stroke patients.
Main Outcome Measures
The percentage and quality of mood assessments in the medical records; and the stroke
patients’ depressive symptoms and their satisfaction with their care.
Results
In the 2010 sample, 47% of the patients (n=48) had documentation of mood in their
medical records. After the implementation of prescheduled follow-ups, 77% of the patients
(n=86) had documented moods. The increase was highly significant (P<.001). During the early outpatient phase, the use of interviews increased from 14%
(n=15) to 45% (n=50) of the patients (P<.001). The increase in the satisfaction with care did not reach statistical significance.
Depressive symptoms recorded at any time were associated with depressive symptoms
at 18 months (P<.001).
Conclusions
Prescheduled follow-ups for all stroke patients, including routine depression screening,
can remarkably improve the compliance with depression screening and the detection
of depression.
Keywords
List of abbreviations:
BI (Barthel Index), DEPS (the Depression Scale)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 09, 2018
Footnotes
Supported by state research funding through the South Karelia Social and Health Care District, Lappeenranta, Finland.
Disclosures: None.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
