Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2021
Trends in Diet Counseling Among Stroke Versus Non-Stroke Patients: Evidence from the NAMCS, 2011-2016.
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Gandrakota Nikhila, Patel Vishal B, Moore Miranda, Benameur Karima, Shah Megha K
Аннотация
INTRODUCTION: Dietary modifications in post-stroke patients facilitated by diet counseling improves post-stroke recovery and stroke recurrence. The extent to which clinicians provide dietary counseling for these patients is unknown.
METHODS: 2011 to 2016 National Ambulatory Medical Care Surveys (NAMCS) data were used to assess trends in post-stroke diet consultations by age. Multivariate logistic regression models assessed the likelihood of dietary counseling provision among patients with and without stroke.
RESULTS: The proportion of patients with stroke aged 60-79 who received diet counseling decreased from 18.2% in 2011 to 5.3%, 11.9%, 8.7%, 13.4%, and 15.2% in 2012-2016, respectively. Among patients without stroke aged 60-79, diet counseling rate decreased from 12.9% in 2011 to 7%, 9.5%, 10.5%, 13.5%, and 12% in 2012-2016, respectively. Similar trends were observed among patients with and without stroke aged over 80.
CONCLUSIONS: The proportion of patients with and without stroke receiving dietary counseling has remained low over the past half-decade. It is likely multifactorial- related to clinician knowledge, patients' receptiveness, and system-level factors of time and reimbursement. Future interventions should explore methods to address barriers to nutrition recommendations for post-stroke patients and patient activation to adopt dietary changes.
METHODS: 2011 to 2016 National Ambulatory Medical Care Surveys (NAMCS) data were used to assess trends in post-stroke diet consultations by age. Multivariate logistic regression models assessed the likelihood of dietary counseling provision among patients with and without stroke.
RESULTS: The proportion of patients with stroke aged 60-79 who received diet counseling decreased from 18.2% in 2011 to 5.3%, 11.9%, 8.7%, 13.4%, and 15.2% in 2012-2016, respectively. Among patients without stroke aged 60-79, diet counseling rate decreased from 12.9% in 2011 to 7%, 9.5%, 10.5%, 13.5%, and 12% in 2012-2016, respectively. Similar trends were observed among patients with and without stroke aged over 80.
CONCLUSIONS: The proportion of patients with and without stroke receiving dietary counseling has remained low over the past half-decade. It is likely multifactorial- related to clinician knowledge, patients' receptiveness, and system-level factors of time and reimbursement. Future interventions should explore methods to address barriers to nutrition recommendations for post-stroke patients and patient activation to adopt dietary changes.