Abstract NS1: Depression Vs Psychiatry Appointments Post Stroke Discharge Phone Call

Stroke(2023)

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摘要
Background: Post-stroke depression (PSD) affects up to one-third of stroke survivors and remains under-recognized. The optimal time for PSD screening seems to be about 30-45 days post-stroke. However, screening and follow up remains insufficient. Methods: Our stroke certified registered nurse contacted stroke patients admitted to Kaiser Permanente Los Angeles in 2021 to assess depression within 30-45 days post discharge using the Patient Health Questionnaire Screening Tool (PHQ9). Two call attempts were made. Based on the PHQ9 scores, patients were referred to different clinical care pathways. Patients who scored10-19 were referred to depression care management (DCM), while 20 and above were referred to psychiatry directly. We collected the demographics, stroke types and discharge disposition inpatients who were lost to follow up and patients who completed the follow up. Data were analyzed using R-Statistics. Results: Among 92 patients, 41 (45%) had follow-up depression screening completed; 13 (32%)received psychiatry referral given severity of depression, and 28 (68%) received a depression care management referral. Of 51 patients who did not complete follow-up screening, 27 (53%)declined to participate in screening, while 22 (43%) could not be reached. Patients who did not receive follow-up screening were older (P=0.02). Race, gender, discharge mRS or length of acute hospital stay did not have a significant effect on patient’s depression screening follow-up status. Patients discharged home with home health showed a trend for better completed follow-ups despite not reaching statistical significance (P=0.07). Conclusion: Raising awareness about the necessity of depression screening and its treatment is of utmost importance for reaching optimal recovery and rehabilitation potential in stroke patients. Post-discharge follow-up and education can be implemented to narrow the PSD recognition gap.
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depression,stroke,abstract ns1
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