Berlin - The range of 291 certified stroke units guarantees acute care for stroke patients in Germany. There is also network of rehabilitation clinics. Nevertheless, the further supply is neither structured nor quality assured, complained Armin Grau, board member of the (DSG) at press conference in Berlin. On the occasion of World Stroke Day, the DSG advocates developing new aftercare concepts to prevent relapses and anxiety disorders. A corresponding one is already available, but is hardly used, explained Grau, just one of several possible approaches.
"There is an undersupply in Germany, especially when it comes to the further supply of medicinal products," said Grau. This includes physiotherapy, occupational therapy and speech therapy - there are delays and interface problems in the outpatient area. "Even depression is still too rarely recognized and treated," says Grau with confidence. This is shown by study by the AQUA Institute. Depression can already begin in the acute clinic, or later when the patient is back home and in 90% of cases visits the family doctor. First and foremost, neurologists and general practitioners should therefore be attentive to the symptoms of depression in stroke patients, says Grau.
Deutsches Ärzteblatt print
The World Stroke Organization developed checklist for aftercare few years ago. The patient can fill this out and then discuss it with the doctor. Grau regards it as useful tool to use this checklist in slightly modified form in Germany. However, doctors are currently hardly using them.
Another approach to improving aftercare would be regional stroke network with stroke coordinators and specialized nurses, so-called stroke nurses. The DSG would like to try out such network and has also submitted this project as part of the innovation fund. It will shortly be decided whether the project will receive funding.
After stroke, around every second person is disabled in way that is relevant to everyday life. Every third person develops an anxiety disorder or depression in the first year, 10% develop dementia, 50% fall. Approximately 5 to 6% of stroke patients will have relapse in the first 90 days after the event. This is shown by studies from Rhineland-Palatinate.
Preventing recurrences with preventive measures
- Antihypertensive drugs
- Physical activity
Simulation studies can be performed here According to about 80% of recurrent strokes prevent through five preventive measures (see left). In cross-sectional study after stroke, only 43% and 25% of patients in Germany achieved guideline-compliant target for blood pressure and cholesterol levels, 78% were overweight and 17% continued to smoke.