Stroke is a long term and complex disease. Every year an estimated 150,000 people in the UK have a stroke. It’s the third biggest killer in the Western world, and many survivors are left disabled and needing rehabilitation.
Approximately 250,000 people in the UK are living with long term disability as a result of stroke. As the population ages, this number will increase so research into the long term needs and treatment of stroke patients is vital.
We have a long history of stroke research that has benefited patients and public health. Our register of stroke patients is the longest running in the world. This not only helps us to investigate all sorts of issues to do with stroke, it also helps the people who commission care to plan health services for the future.
The stroke register
The stroke register was set up in 1988 to register the new stroke cases in Lambeth (200-250 cases each year) to investigate why Lambeth’s death rates were worse than those in Tunbridge Wells’.
The register records patients’ risk factors, such as high blood pressure and cholesterol and details of their treatment such as whether they were admitted to a specialist stroke unit and how much physiotherapy they received. Where possible, we do yearly follow-up checks.
The register has helped us to determine patients’ prognosis and the best and most cost effective treatments. It provides such useful information that was used by the Department of Health for its:
- stroke strategy (PDF 820Kb) to modernise stroke services and deliver the latest treatments across the UK
- ASSET toolkit which helps the people who commission care to plan for the future by indicating patients’ needs at certain time points after their stroke.
It was also used by the National Audit Office to model the most efficient way of monitoring and treating stroke.
Depression and stroke
Approximately 1/3 stroke patients suffer depression for up to 10 years after their stroke.
We are working with psychiatrists from South London and Maudsley to see if depression can be reduced using cognitive behavioural therapy (CBT).
Disability and stroke
About 1/3 stroke patients have a severe disability as a result of their stroke. We have a project that is tracking patients’ rehabilitation progress. These results will be used to develop stroke recovery charts, similar to those used to monitor baby growth rates.
There will be:
- a baseline assessment (shortly after the stroke)
- chart showing predicted recovery
- follow-up assessments to check that recovery is proceeding as expected.
If patients do not recover at the expected rate, or suddenly stop showing improvement, it will prompt an intervention to see what they need to continue their rehabilitation, eg a bout of physiotherapy.