Randomized Trial of an Attending Nurse Model of Care for Acute Stroke

Introduction: Poor medication adherence and insufficient stroke related knowledge may contribute to worse outcomes. Hypothesis: A relationship-based attending nurse (AN) model of inpatient care for stroke patients will enhance medication adherence, stroke-related knowledge, and QOL after hospital discharge. Methods: We performed a pseudo-randomized trial of AN + standard care vs. standard care at a single comprehensive stroke center (CSC). We enrolled patients with ischemic stroke, TIA, or ICH. The AN intervention consisted of a dedicated nurse focused on individual patient goals, expectations, and disease related knowledge deficits. After discharge, subjects were consented and assessed via structured telephone interviews using the Morisky Medication Adherence Scale (MMAS-4), Stroke Patient Education Retention tool (SPER), and Stroke Impact Scale (SIS). Results: We randomly allocated 278 subjects to AN and 392 to standard models of care; 47% and 43% consented to participate, respectively. Patients in the ...