| QUESTIONS |
YES |
EVIDENCE |
| Has this patient had a stroke? |
|
Approximately 25% of stroke survivors experience a recurrent stroke within 5 years. |
| Is this patient experiencing TIAs? |
|
The risk of stroke for individuals with TIA is 5% within 48 hours, 8% within 1 month, 12% within 1 year and up to 30% within 5 years. |
| Does the patient have uncontrolled high blood pressure? |
|
Untreated high blood pressure increases the risk for stroke 3-4 times. |
| Does the patient require multiple medication? |
|
Patient adherence to medications can be compromised with multiple medications and dosage schedules. |
| Are medications required that are not currently covered by a drug plan? |
|
The newest medications for stroke treatment may not yet be funded automatically and a Section 8 form might need to be filled out in order to qualify for coverage. |
| Does the patient have diabetes? |
|
Diabetics have 1.5-2.5 greater risk for ischemic stroke. Diabetes is also strongly correlated with high blood pressure, high cholesterol and being overweight. |
| Does this patient have asymptomatic carotid stenosis? |
|
Individuals with atherosclerosis may have no TIAs or other symptoms. Over 5 years they have a 11% risk for stroke. |
| Is there history of coronary vascular disease? |
|
Having coronary vascular disease increases by 2 times the risk of ischemic stroke. |
| Does the patient have atrial fibrillation? |
|
Individuals with atrial fibrillation have 3-5 times greater risk for ischemic stroke |
| Does the cholesterol level need to be lowered? |
|
Following a stroke, patients should receive statins to lower cholesterol. |
| Is the patient a smoker, or living with second hand smoke? |
|
Active smoking increases the risk of stroke two to six times. Passive smoking doubles the risk for stroke. |
| Is the patient overweight? |
|
Being overweight increases risk of stroke, high blood pressure, high cholesterol and diabetes. |
| Is the patient physically inactive? Are there blocks to supervised activity programs? |
|
A sedentary lifestyle is an independent risk factor for stroke and also increases the risk of high blood pressure, becoming over weight, diabetes and heart disease. |
| Is the patient a heavy drinker? |
|
More than 1-2 drinks per day (maximum of 9 for women and 14 for men per week) and binge drinking can double the risk of ischemic stroke and increase the risk of hemorrhagic stroke 2-3 fold. Heavy drinking is also linked to rising blood pressure and obesity. |
| Does the patient lack a support system (of family and friends) at home? |
|
Social isolation is associated with higher mortality rate in males and females. |
| Does the patient need transportation to appointments and outings? |
|
Lack of access to medical treatment and services can interfere with necessary care. |
| Does this person fall into an at-risk socioeconomic group defined by low education, or lower occupational level? For example: Does the individual rent his/her home? |
|
Socioeconomic factors account for a significant proportion of the variation in heart disease across Ontario. Living conditions, education and occupational levels are key predictors of heart disease. For example; there is evidence that house ownership is a discriminating measure of SES in predicting risk of coronary heart disease. |
| Are there safety/health concerns in the patient's home? |
|
Seniors and those with disabilities may be at greater risk for falls and injuries. |
