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| A/Prof Cadilhac |
Australian patients with stroke are not being adequately
assessed for rehabilitation due to health professionals’ preconceived beliefs
about suitability, according to latest research from UniSA undertaken in
collaboration with Monash University.
Stroke Foundation data from 2011 and 2013 indicated that
fewer than half the patients with acute stroke in Australian hospitals were
assessed for rehabilitation.
“These results compare
unfavourably with audits conducted the UK and the US where about 90% of
patients have received rehabilitation assessments,” said study author Associate
Professor Dominique Cadilhac, Head of Translational Public Health and
Evaluation Division, Stroke and Ageing Research in the School of Clinical
Sciences at Monash Health.
“Australian
clinical guidelines include the good practice point that every patient with
stroke, who is not for palliative care, should be assessed for further
rehabilitation.”
To
address concerns regarding the low proportion of Australian patients with
stroke being assessed for rehabilitation, the Australian Stroke Coalition
developed an evidence-based and patient-centred Rehabilitation Assessment Tool
in 2011.
Associate
Professor Cadilhac said the Assessment Tool was designed to guide health
professionals to make objective decisions regarding the rehabilitation
requirements of every patient with stroke admitted to hospital.
“Our
latest research reveals that health professionals working on acute stroke units
believe there are not enough rehabilitation services to meet the needs of
patients with stroke.”
“We’ve
also shown that patients with rehabilitation needs are not always referred to
rehabilitation services, and beliefs about the purpose of rehabilitation
assessments vary between health professionals,” said Associate Professor
Cadilhac.
Among
the health professionals interviewed within the 10 study stroke units often the
patients with severe stroke, stroke-related cognitive deficits or co-existing
dementia were considered unlikely to benefit from rehabilitation and so were
not referred for assessment.
“It
is also significant that two-thirds of patients with stroke in Australian
hospitals do not receive documented assessments of mood or continence problems.”
“Rehabilitation
interventions can be effective for addressing problems with mood or urinary
incontinence after stroke, but without being provided with the opportunity for rehabilitation
assessment, it is unlikely that appropriate management plans will be organised
for such conditions,” said Associate Professor Cadilhac.
“Consistent
use of the Rehabilitation Assessment Tool will enable more holistic plans to be
developed for each patient in the early post-stroke period, which we believe
will lead to enhanced clinical outcomes.”
