Canadian Stroke Best Practice Recommendations: Mood, Cognition and Fatigue following Stroke, 6th edition update 2019

Author:

Lanctôt Krista L12,Lindsay M Patrice3ORCID,Smith Eric E45,Sahlas Demetrios J6,Foley Norine7,Gubitz Gord8910,Austin Melissa11,Ball Kristyn12,Bhogal Sanjit7,Blake Treena13,Herrmann Nathan12,Hogan David14,Khan Aisha15,Longman Stewart16,King Andrea17,Leonard Carol18,Shoniker Tricia19,Taylor Trudy20,Teed Moira3,de Jong Andrea3,Mountain Anita2122,Casaubon Leanne K21023,Dowlatshahi Dar24,Swartz Richard H12,

Affiliation:

1. Sunnybrook Research Institute, Toronto, Canada

2. University of Toronto Faculty of Medicine, Toronto, Canada

3. Heart and Stroke Foundation of Canada, Toronto, Canada

4. Calgary Stroke Program, Calgary, Canada

5. Hotchkiss Brain Institute, University of Calgary Cumming School of Medicine, Calgary, Alberta

6. Division of Neurology, Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Canada

7. workHORSE Consulting Services, London, Canada

8. Queen Elizabeth II Health Sciences Centre, Halifax, Canada

9. Department of Medicine (Neurology), Dalhousie University, Halifax, Canada

10. Canadian Stroke Consortium, Ontario, Canada

11. Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada

12. Health Sciences Centre, Winnipeg, Canada

13. GF Strong Rehabilitation Centre, Vancouver, Canada

14. University of Calgary Cumming School of Medicine, Calgary, Canada

15. Montreal University Health Center, Montreal, Canada

16. Calgary Stroke Program, Alberta Health Services, Calgary, Canada

17. Nova Scotia Health Authority, Halifax, Canada

18. Audiology and Speech-Language Pathology Program, University of Ottawa, Ottawa, Canada

19. Parkwood Institute, London, Canada

20. Carewest Dr. Vernon Fanning Centre, Calgary, Canada

21. Dalhousie University Division of Physical Medicine and Rehabilitation, Halifax, Canada

22. Nova Scotia Rehabilitation Centre Site, Halifax, Canada

23. Toronto Western Hospital, University Health Network, Toronto, Canada

24. University of Ottawa Faculty of Medicine, Ottawa, Canada

Abstract

The 2019 update of the Canadian Stroke Best Practice Recommendations (CSBPR) for Mood, Cognition and Fatigue following Stroke is a comprehensive set of evidence-based guidelines addressing three important issues that can negatively impact the lives of people who have had a stroke. These include post-stroke depression and anxiety, vascular cognitive impairment, and post-stroke fatigue. Following stroke, approximately 20% to 50% of all persons may be affected by at least one of these conditions. There may also be overlap between conditions, particularly fatigue and depression. If not recognized and treated in a timely matter, these conditions can lead to worse long-term outcomes. The theme of this edition of the CSBPR is Partnerships and Collaborations, which stresses the importance of integration and coordination across the healthcare system to ensure timely and seamless care to optimize recovery and outcomes. Accordingly, these recommendations place strong emphasis on the importance of timely screening and assessments, and timely and adequate initiation of treatment across care settings. Ideally, when screening is suggestive of a mood or cognition issue, patients and families should be referred for in-depth assessment by healthcare providers with expertise in these areas. As the complexity of patients treated for stroke increases, continuity of care and strong communication among healthcare professionals, and between members of the healthcare team and the patient and their family is an even bigger imperative, as stressed throughout the recommendations, as they are critical elements to ensure smooth transitions from acute care to active rehabilitation and reintegration into their community.

Funder

Heart and Stroke Foundation of Canada

Publisher

SAGE Publications

Subject

Neurology

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