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Abstract Details

Optimizing Post-stroke Continuity of Care: Insights from Three Models of Outpatient Follow-up
Cerebrovascular Disease and Interventional Neurology
P5 - Poster Session 5 (11:45 AM-12:45 PM)
4-017

To assess adherence and predictors of follow-up among post-stroke patients among varied outpatient stroke follow-up care models.
Outpatient follow-up after ischemic stroke is essential for managing vascular risk factors and preventing recurrence. However, adherence is often suboptimal. Models of care vary, including physician-led clinics, advanced practice provider (APP) rapid-access clinics, and hybrid clinics (in person or telehealth). Understanding differences in adherence and identifying predictors of attendance may inform strategies to optimize secondary prevention.
We conducted a retrospective analysis of patients discharged after stroke and scheduled for outpatient follow-up in three models: traditional physician clinic, APP rapid-access clinic, and hybrid telemedicine clinic. Demographic and clinical characteristics were collected. The primary outcome was adherence to follow-up. Telehealth and in-person encounters were compared, and logistic regression was used to identify predictors of adherence.

Of 1,539 stroke discharges, 1,344 (87.3%) were scheduled for follow-up (259 physician clinic, 149 APP clinic, 936 hybrid telemedicine). Overall adherence was 64.8%, with 74.8% in person and 25.2% by telehealth. The hybrid telemedicine model had the highest adherence (p < 0.001). Younger age, history of tobacco use, absence of dementia, shorter wait times, and discharge to home or rehabilitation were associated with higher adherence. Male patients and those transferred from other hospitals were more likely to use telehealth. Dementia (OR 0.38) and longer wait times (OR 0.99 per day) predicted poor adherence.

Among the three outpatient models, hybrid telemedicine had the highest adherence. Predictors such as dementia and longer wait times identified patients at risk for missed follow-up. Incorporating these factors into discharge planning and clinic design may improve attendance and strengthen secondary stroke prevention.
Authors/Disclosures
Kelliann E. Donovan, Medical Student
PRESENTER 		Ms. Donovan has nothing to disclose.
Turkan A. Esensoy, MD Dr. Esensoy has nothing to disclose.
Carolina Parker, MD (UAB) Dr. Parker has nothing to disclose.
Michelle Nguyen, MD (Michelle Nguyen) Dr. Nguyen has nothing to disclose.
Samar J. Bahna Miss Bahna has nothing to disclose.
Toby I. Gropen, MD (University of Alabama At Birmingham) Dr. Gropen has nothing to disclose.
Michael J. Lyerly, MD, FAAN (University of Alabama At Birmingham) Dr. Lyerly has nothing to disclose.