Did you know the southeast is recognized as the Stroke Belt? That means residents of North Carolina are 20-40% more likely to die of stroke than those living in other parts of the country.
Every 40 seconds, someone in the United States has a stroke and it is a leading cause of long-term adult disability. Researchers at Wake Forest University School of Medicine, the academic core of Atrium Health, previously received $14 million in funding over five years to support the first statewide COMprehensive Post-Acute Stroke Services (COMPASS) study for post-stroke treatment. The award was received from the Patient-Centered Outcomes Research Institute – an independent, non-profit, nongovernmental research funding organization authorized by Congress – to determine whether longer-term, post-stroke care helps stroke patients across North Carolina to improve their daily function. A secondary goal was to find ways to reduce caregiver stress by providing better resources once stroke survivors return home.
COMPASS: Guiding the Way
The COMPASS study compared the health status of stroke patients who received conventional post-hospitalization treatment to that of patients who received comprehensive care based on a model developed by a team of physicians, nurses, therapists, pharmacists, health system and human services leaders, and patient and caregiver stakeholders. Over 10,000 patients from across North Carolina were enrolled in the study.
|“This is a great example of how our academic learning health system can take research findings and develop solutions to help improve the health of patients right here at home and across the country,” - Pamela Duncan, PhD, professor of neurology|
The numerous insights and resources gained during the study were consolidated and made available to anyone on the COMPASS study website for free, from advice on how to prevent a stroke to recommendations on how patients can find their way forward to recovery, independence and good health. The website also houses a comprehensive community resource directory built to support patients, caregivers, and health and human services teams.
“This is a great example of how our academic learning health system can take research findings and develop solutions to help improve the health of patients right here at home and across the country,” said Pamela Duncan, PhD, professor of neurology at Wake Forest University School of Medicine.
This massive collaboration and extensive work was also incorporated into the Post-Stroke Care Section of the North Carolina Stroke Care Plan, under development by the Stroke Advisory Council.
The Next Phase: COMPASS CP
The combination of stroke experts at Atrium Health Wake Forest Baptist’s Comprehensive Stroke Center and Wake Forest Innovations resulted in the creation of COMPASS-CP (COMprehensive Post-Acute Stroke Services – Care Plan), a transformative digital health platform focused on post-stroke care that’s also available to other hospitals and health systems across the country. The Center offers translational research pilot awards for competitive studies focusing on preclinical models, population research and clinical-translational research. Established for School of Medicine researchers, the Center encourages multidepartmental and collaborative projects.
“COMPASS-CP allows clinicians to securely receive and easily interpret remote monitoring data, such as blood pressure and physical activity, which helps them and their patients make timely decisions and adjustments to lifestyle behaviors and medications aimed at reducing the likelihood of patients suffering future strokes,” said Duncan.“
Prevent a Stroke
While genetics can play a factor in stroke-risk, certain lifestyle adjustments may still make a stroke less likely. As for how many people are genetically at risk for stroke, Cheryl Bushnell, MD, professor of neurology at Wake Forest University School of Medicine, recently told AARP that can be a difficult question to answer.
“The interesting thing, though, is that most strokes are linked in some way to other factors, like blood pressure or cholesterol,” Bushnell said. Lifestyle choices can play a contributing factor in triggering a stroke, even for those with a genetic predisposition.
The below tips can help reduce the likelihood of stroke:
- Choose healthy foods and drinks: Eat plenty of fresh fruits and vegetables. Eating foods low in saturated fats, trans fat, and cholesterol and high in fiber can help prevent high cholesterol. Limiting salt can also lower blood pressure – high cholesterol and high blood pressure increase the chances of having a stroke.
- Take appropriate medicine: If prescribed medicine to treat heart disease, high cholesterol, high blood pressure, or diabetes, follow doctor’s instructions carefully.
- Get regular physical activity: For adults, the recommended amount of exercise is 2 hours and 30 minutes of moderate-intensity aerobic physical activity, such as a brisk walk, each week.
- Avoid smoking: Cigarette smoking greatly increases the likelihood of having a stroke.
How to Recognize a Stroke
One approach to dealing with the opioid epidemic is to reduce the supply in households with organized disposal efforts such as drop boxes or take-back events.
A stroke is a medical emergency so the faster a patient receives proper treatment, the better the chances for recovery. Bushnell told AARP a useful tip on how to identify a stroke when they’re happening is the acronym BE FAST:
- B = Balance: Watch out if it’s suddenly a struggle to balance.
- E = Eyes: Seeing double, blurred vision or losing sight in one or both eyes without pain could be a sign of stroke.
- F = Face Drooping: Does one side of the face droop or is it numb? Ask the person to smile. Is the person's smile uneven?
- A = Arm Weakness: Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
- S = Speech Difficulty: Is speech slurred?
- T = Time to call 911
Access to Quality Care
With increased awareness of symptoms, stroke patients are getting to hospitals quicker, and physicians have more treatment options. Atrium Health Wake Forest Baptist’s Telestroke Network provides around-the-clock access to expert stroke care for patients in smaller communities. Emergency department physicians at community hospitals within the network receive on-demand consultation with a Wake Forest Baptist stroke neurologist. Through the efforts of the Telestroke Network, 40% of patients seen have received the emergency clot-busting medicine tPA and more than 60% of patients have been able to receive the care they need while remaining at their local hospital.
Thanks in large part to clinical research excellence and improved access to care and resources, Atrium Health received the American Heart Association’s “Get With The Guidelines – Stroke” Gold Plus Quality Achievement Award at 12 facilities across North Carolina and Georgia. The designation honors Atrium Health for its commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines.