The comprehensive system of outpatient stroke care has not been as well established as that of inpatient stroke care. Yet, in terms of brain health and stroke care, prevention is perhaps the most effective intervention. The cost to prevent cerebrovascular and cardiovascular disease has increased to over 300 billion dollars annually in the United States. Quantitative modeling has shown that up to 80% of vascular events after stroke can be prevented by addressing modifiable risk factors through pharmacologic and behavioral interventions. Risk factor awareness and control remains poor in stroke survivors. A comprehensive outpatient stroke care model could provide a more efficient secondary stroke prevention strategy, thus reducing the cost. A collaborative registry is needed for tracking patient-reported outcomes, evaluating adherence to clinical standards, maintaining quality care and following post stroke complications.

We developed the Follow up After Stroke, Screening and Treatment (FASST) clinic. The outpatient visits are a collaborative effort of pharmacists, neurology residents, students and ancillary staff led by vascular neurologists. The services provided in the clinic include stroke education, uncontrolled vascular risk factors management, medication adherence assessment, and treatment of post stroke complications. Validated instruments are used to assess for depression, anxiety, sleep disorders, cognitive impairment, post-stroke disability, social support, quality of life and functional status to aid and monitor recovery. A consolidated referral base includes Physiatry, Neuropsychology, Endocrinology, and Sleep.

FASST clinic provides a platform for tracking quality of stroke care and allows for collaborative decision making for stroke survivors.