Anforderungen an eine patientenorientierte Ergebnisforschung beim Schlaganfall

Zusammenfassung

Da die Beurteilung der Anforderungen an eine patientenrelevante Ergebnisforschung beim Schlaganfall auf zahlreichen Voraussetzungen beruht, sind diese zuvor zumindest im Überblick darzustellen: die epidemiologische Dimension des Schlaganfalls und die damit verbundene gesellschaftliche Herausforderung, die Besonderheiten des Krankheitsbildes und die daraus resultierenden zahlreichen Outcome-Dimensionen, die Strukturen, Prozesse und Ergebnisse der Schlaganfallversorgung, die bisherige Outcome-Messung mit ihren patientenrelevanten Ergebnissen inklusive Lebensqualität, die große Bedeutung der individuell zugeschnittenen Rezidiv- und Sekundärprophylaxe sowie der adäquaten Therapie von Begleit- und Folgeerkrankungen. Erst auf dieser Grundlage lassen sich am Ende als Schlussfolgerungen Desiderate an eine patientenrelevante Ergebnisforschung formulieren.

Summary

Because assessing the requirements for patient-orientated outcome research on stroke rests on numerous prerequisites, these have to be defined beforehand, at least in a general sense. They consist of the epidemiological dimensions of stroke and related societal challenges; the special features of this disease entity with resulting numerous outcome dimensions; the structure, processes and results of the management of stroke; current outcome measurements with their patient-relevant results including quality of life; and the great importance of individually adapted prevention of recurrences and secondary events, as well as adequate treatment of associated diseases or sequelae. It is only on this basis that in the end those features can be formulated that are needed for patient-relevant outcome research.

Literatur

• 1 AHA/ASA Conference Proceedings . Measuring and Improving Quality of Care. A Report From the American Heart Association/American College of Cardiology First Scientific Forum on Assessment of Healthcare Quality in Cardiovascular Disease and Stroke. Quality of Care and Outcomes Research in CVD and Stroke Working Groups.  Stroke. 2000;  31 1002-1012
• 2 Management of Adult Stroke Rehabilitation Care . A Clinical Practice Guideline.  Stroke. 2005;  36 e100-e143
• 3 Gresham G E, Duncan P W, Stason W B. et al .Post-Stroke Rehabilitation. Clinical Practice Guideline, No. 16. Rockvilee, Md: US Department of health and Human Services, Public Health Service, Agency for Health Care Policy and Research. May 1995 ; AHCPR Publication No. 95-0662
• 4 Stroke Unit Trialists’ Collaboration .Organized inpatient (Stroke Unit) Care for Stroke; in: Cochrane Library, . Issue 1 2002
• 5 Stroke Unit Trialists’ Collaboration (2004) .Organized inpatient (Stroke Unit) Care for Stroke (Cochrane-Review); in: The Cochrane Library, . Issue 2, Chichester, UK: John Wiley & Sons, LTD. (Analysis by Don Hess & Peter Langhorne) 2004
• 6 Royal College of Physicians .National Guidelines for Stroke. 2nd ed. Prepared by the Intercollegiate Stroke Working Party. London: RCP 2004. Available at: http://www.replondon.ac.uk/pubs/books/stroke/index.htm. Accessed July 30, 2005
• 7 Duncan P W, Jorgensen H S, Wade D T. Outcome measures in acute stroke trials: a systematic review and some recommendations to improve practice.  Stroke. 2000;  31 1429-1438
• 8 Hoffman J. „Nothing can be done”: social dimensions of the treatment of stroke patients in a general hospital.  Urban Life and Culture. 1974;  3 50-70
• 9 McKevitt C, Redfern J, Mold F, Wolfe C. Qualitative Studies of Stroke A Systematic Review.  Stroke. 2004;  35 1499-1505
• 10 Touze E, Varenne O, Chatellier G, Peyrard S, Rothwell P M, Mas J L. Risk of myocardial infarction and vascular death after transient ischemic attack and ischemic stroke: a systematic review and meta-analysis.  Stroke. 2005;  36 2748-2755