Study : Long Term Impact of Stroke

InnoHEALTH Magazine — Mon, 26 Nov 2018 09:36:42 +0000

A new study looks at what problems affect people most after a stroke and it provides a broader picture than what some may usually expect to see.

Stroke affects more than just physical functioning, according to a study recently published in Neurology, the medical journal of the American Academy of Neurology.

“People who have an only mild disability can often have ‘hidden’ problems that can really affect their quality of life,” said study author Irene L. Katzan, MD, MS, of the Cleveland Clinic in Ohio and a member of the American Academy of Neurology.

“And for people with more disability, what bothers them the most? Problems with sleep? Depression? Fatigue? Not many studies have asked people how they feel about these problems, and we doctors have often focused just on physical disability or whether they have another stroke.”

The study involved 1,195 people who had an ischemic stroke or a stroke where blood flow to part of the brain is blocked. They were asked questions about their physical functioning, fatigue, anxiety, sleep problems, thinking skills such as planning and organizing, how much their pain affects other aspects of their life and their satisfaction with their current social roles and activities. Participants took the questionnaires an average of 100 days after their stroke, and about a quarter of the participants needed help from a family member to fill out the questionnaires. Researchers also measured their level of disability.

The people with stroke had scores that were considerably worse than those in the general population in every area except sleep and depression. Not surprisingly, the area where the people with stroke were most affected was physical functioning, where 63 percent had scores considered meaningfully worse than those of the general population, with an average score of 59, where a score of 50 is considered the population average.

On the question about whether they were satisfied with their social roles and activities, 58 percent of people with stroke had scores meaningfully worse than those of the general population.

“People may benefit from social support programs and previous studies have shown a benefit from efforts to improve the social participation of people with stroke, especially exercise programs,” said Katzan.

The thinking skills of people with stroke in executive functions, or planning and organizing, were also affected, with 46 percent having scores that were meaningfully worse than the population average.

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“The social participation and executive functioning skills are areas that have not received a lot of attention in stroke rehabilitation,” Katzan said. “We need to better understand how these areas affect people’s well-being and determine strategies to help optimize their functioning.”

Limitations of the study include that the questionnaires did not ask about other problems that can occur after stroke, such as communication issues.

Also, the study participants had milder strokes on average than people with stroke overall and the average age of participants was 62, which is lower than the average age of 69 for people with stroke overall.

Informatively, American Academy of Neurology is the world’s largest association of neurologists and neuroscience professionals, with 34,000 members. AAN is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, concussion, Parkinson’s disease, and epilepsy.

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Menace of Non-Communicable diseases: A far reaching impact

InnoHEALTH Magazine — Wed, 28 Mar 2018 08:49:26 +0000

Non-communicable diseases (NCDs) represent a major peril to the economic growth and development and human health of any nation. The economic loss to India is pegged at $4.58 trillion before 2030 due to NCDs and mental health. The vicious cycle of high out-of-pocket expenditure on health, poor economic growth, workforce productivity loss and rising disease burden are intricately linked to the rising menace of NCDs.

The South Asian region─with a population of more than 1.7 billion─is experiencing a marked demographic transition─characterised by declining birth and death rates and an increasingly aging population. This increase in longevity has also been accompanied by a rise in the prevalence of NCDslike diabetes (78 million cases in 2015). India has the second highest number of diabetic patients in the world, at about 69 million, after China, and this figure is likely to reach 140 million by 2040 and almost half of them remain un-diagnosed. A recent study showed that seven out of ten diabetics in India – especially those in the 20-24 age group – do not take enough steps to control their blood sugar level – even after diagnosis.

The Economic Impact of Diabetes, As per a study conducted by the Indian Institute of Public Health, the number of diabetes patients in the country is likely to go up to 120 million in next 20 years as against the current 70 million. On an average a diabetic patient spends about INR 25,000 annually to manage the disease and its associated complications. Beyond placing a financial strain on the patient due to treatment expenditures, poor management of diabetes significantly impacts the patients’ quality of life: it may lead to loss of productivity due to multiple hospital visits, elevating rates of absenteeism, diminishing the energy and focus of a productive workforce, and depleting critical workplace skills ultimately leading to reduced mobility and span of life. Diabetes related complications like kidney failure, nerve damage along with obesity, dyslipidemia and hypertension make diabetes management quite complex for clinicians.

In this context, it becomes important that healthcare professionals have access to more educational resources to remain updated about how to tackle the diabetes epidemic. But due to scarcity of time and high patient load in South Asian healthcare facilities, medical practitioners find it very difficult to update their knowledge. Remaining updated can help clinicians offer better diabetes management options to their patients.

A Possible Solution: E-Learning Courses e-Learning programs can help clinicians in acquiring skills required to address the growing complex management of diseases. E-learning courses can be tailored to fit the clinicians schedule, delivering content right at the moment when it is demanded by the doctor. Interactive e-learning programs also offer peer to peer learning, thus enabling clinicians to discuss learning from key cases. Those e-learning programs which also offer the opportunity of contact classes, offer a richer and immersive learning experience.

An effective e-learning program will incorporate guidelines for determining the correct and appropriate blend of instructional strategies, including on-line learning, face-to-face instruction, and skill demonstrations, thus facilitating the learning of a clinician far beyond than traditional learning materials. Unlike traditional CMEs, e-learning can be designed to be self-paced, and research has indicated that e-learning reduces the learning time by at least 25-60% when compared to traditional learning, which can be an added advantage for time-constrained clinicians.

Intelligent e-learning management systems also adapt and learn from the learners’ aptitude and change and deliver a personalized learning experience. The right mix of video, audio, and text content formats help to ensure that delivery of content is mapped to the medium most appropriate & relevant to concept development.

Keeping in mind these perspectives, a Six Months Certification Course in Diabetes in partnership with Fortis C-DOC Hospital was launched by BMJ in South Asia. This course is endorsed by the Royal College of Physicians. This is a six months online learning course offered in two formats: with hands-on training and online-only – to cater to the learning needs of clinicians in South Asia.

Courses such as these will go a long way in knowledge & skill upgradation for clinicians in areas which the country faces a high disease burden. Such courses are clinician-centric and learner-led, and have been developed keeping in mind the real and on-ground challenges faced by doctors in South Asia.

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Study : Long Term Impact of Stroke

Menace of Non-Communicable diseases: A far reaching impact