Impact of a Nursing Educational Consultation on the Patient's Adherence to Their Post-stroke Care Plan.

Impact of a Nursing Consultation at the End of Hospitalization on Adherence to the Post-stroke Care Plan for Patients Admitted to the Vascular Neurology Unit

This prospective, single-center, randomized study will evaluate the impact of implementing an educational nursing consultation at the end of hospitalisation for stroke patients returning home on overall adherence to stroke-related medication during the 4-month follow-up visit.

Stroke is the leading cause of acquired disability in adults and represents a public health problem in terms of frequency, severity, and cost.

In France, the prevalence of stroke is estimated at 1.6%, with about 150,000 new cases each year. The risk of recurrence after a stroke remains high, nearly 6% at 1 year and 13% at 5 years. Some strokes and their recurrences are preventable through targeted prevention, particularly addressing cardiovascular risk factors.

The care pathway for a patient suffering from a stroke or TIA in a medical service includes:

• acute care in stroke units, which allows more than half of patients to return home
• a post-stroke consultation, 3 to 6 months after the stroke. According to the WHO, 50% of patients with chronic illnesses poorly adhere or adhere little to their treatments. Interventions are necessary to improve adherence to drug and rehabilitation therapies. They raise awareness of the risks of relapse through a better understanding of the disease and control of risk factors. Increased efforts to enhance awareness of stroke and secondary prevention drug treatments are warranted.

In the stroke care pathway, therapeutic education is an integral part of secondary prevention. It is an essential complement to the management of patients following a stroke and should be initiated as early as possible after the acute phase, hence during the stay in the neurological intensive care unit. However, ETP programs are scarce within general hospitals. Of about twenty programs listed in Nouvelle Aquitaine, only a quarter are accessible in general hospitals. The implementation of a nursing educational consultation, at the end of the acute management of the stroke, will allow for conveying the key messages of secondary prevention.

The investigators of this research propose to study the impact of this nursing educational consultation on the patient's adherence to their post-stroke care plan.

Inclusion Criteria:

• Patients admitted to the Neurovascular Unit (UNV) of CHCB for ischemic stroke and/or hemorrhagic stroke confirmed by brain imaging and/or TIA with an ABCD2 score >5,
• Patients whose discharge orientation is a return home
• Age ≥ 18 years
• NIHSS < 15
• Montreal Cognitive Assessment (MoCa) > 21/30
• Free and informed consent signed by the patient.
• Person affiliated with or a beneficiary of a social security scheme

Exclusion Criteria:

• Patients admitted for mechanical thrombectomy, outside the Basque Coast Hospital (CHCB)
• Rankin score estimated at discharge ≥ 4
• Patients requiring assistance from a third party at home for the management of their medication or with stroke follow-up at Prado
• Patients placed under protection measures