Respiratory physician Lutz Beckert considers chronic obstructive pulmonary disease management, including the prevention of COPD, the importance of smoking cessation and pulmonary rehabilitation, and the lifesaving potential of addressing treatable traits. He also discusses the logic of inhaler therapy, moving from single therapy to dual and triple therapy when indicated, as well as other aspects of management
Active provision of information to stroke survivors favoured over passive approaches
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Active provision of information to stroke survivors favoured over passive approaches
What are the effects of active or passive information provision for stroke survivors or their identified carers?
This review found evidence that the addition of active information provision to usual care may slightly improve some important stroke survivor outcomes. Actively providing information may improve knowledge of stroke and stroke services, increase some aspects of stroke survivor satisfaction, slightly reduce cases and symptoms of anxiety and depression in stroke survivors, and improve quality of life.
Active interventions included information courses, interactive follow-up phone conversations or review by stroke nurse specialists.
However, providing information passively may have a slightly negative effect on survivor anxiety and depression. Passive information consisted of generic information provided by pamphlet.
There was no direct evidence comparing active and passive information provision. Observation of the indirect comparison via usual care, which must be interpreted with caution, suggests there may be a divergence of effect on stroke survivor symptoms of anxiety and depression.
There was extensive variation in the content and delivery format of the interventions. Few studies included participants with aphasia and cognitive problems. This substantially limits the applicability of the results, given that approximately one-third of stroke survivors experience aphasia and even more experience cognitive impairment.
Reviewers did not have high confidence in the estimate of effect for any of the outcomes as there was high risk of bias from the included studies, with serious concerns over attrition from the studies. In addition, although there were some data to address the primary outcomes and the majority of secondary outcomes for this review, few studies contributed to each of the outcomes studied.
Context A stroke is a sudden loss of brain function caused by lack of blood supply. Stroke can lead to death or physical and cognitive impairment, and can have long-lasting psychological and social implications.
Research shows stroke survivors and their families are dissatisfied with information provided to them and have a poor understanding of stroke and associated issues.
Crocker TF, et al. Information provision for stroke survivors and their carers. Cochrane Database Syst Rev 2021;11:CD001919. This review contains 33 trials with a total of 5255 stroke survivors and 3134 carers.