Table 2.
Behavioral and lifestyle risk factors identified by COMPASS nurse via COMPASS-CP questionnaires, July 2016-February 2018.
| Behavioral and Lifestyle Risk Factors | N | n (%) |
|---|---|---|
| Know your Numbers—Lack of Knowledge of Stroke Risk Factors* | ||
| High Blood Pressure | 871 | 315 (36.2) |
| Smoking | 871 | 651 (74.7) |
| Diabetes | 871 | 689 (79.1) |
| Atrial Fibrillation | 871 | 801 (92.0) |
| Heart Disease | 871 | 760 (87.3) |
| High Cholesterol | 871 | 472 (54.2) |
| Physical Inactivity | 871 | 756 (86.8) |
| Engage | ||
| Physical Mobility and Safety Concerns | 871 | 292 (33.5) |
| Fall in Last 3 Months | 871 | 200 (23.0) |
| ADL Limitation† | 871 | 181 (20.8) |
| IADL Limitation† | 871 | 149 (17.1) |
| Depression (PHQ-2) † | 871 | 308 (35.4) |
| Upper Extremity Deficits | 871 | 179 (20.6) |
| Patient Stress | 871 | 273 (31.3) |
| Family Stress | 871 | 90 (10.3) |
| Support †† | ||
| Limited Instrumental Social Support | 871 | 282 (32.4) |
| Limited Emotional Social Support | 663 | 60 (9.0) |
| Willingness | ||
| Low Medication Adherence (MGLS) † | 871 | 169 (19.4) |
| Cognitive Deficits | 871 | 330 (37.9) |
| Financial Challenges to Medication Management | 871 | 159 (18.3) |
| Polypharmacy (≥5 medications/day)‡ | 871 | 639 (73.4) |
| Access to Care | ||
| Does not Have PCP† | 871 | 62 (7.1) |
| Has not Seen PCP in Last 3 Months † | 871 | 122 (14.0) |
| Has seen PCP in Last 3 Months but Not Since Stroke† | 871 | 199 (22.8) |
| No Home Health Referrals at Hospital Discharge | 759 | 535 (70.5) |
| No Outpatient Therapy Referrals at Hospital Discharge§ | 536 | 414 (77.2) |
| Self-Rated Health ** | ||
| Poor or Fair | 867 | 174 (20.1) |
| Caregiver Wellbeing ‡‡ | ||
| Caregiver Stress | 328 | 112 (34.1) |
| Poor or Fair Self-Rated Health** | 298 | 34 (11.4) |
| Health Issues or Responsibilities that Interfere with Caregiving§ | 295 | 61 (20.7) |
Unless otherwise noted, “No Response” was included in the numerator to avoid missing potential care concerns.
ADL = Activities of Daily Living; IADL = Instrumental Activities of Daily Living; MGLS = 4-item Morisky Green Levine Medication Adherence Scale; PCP = Primary Care Physician; PHQ-2 = 2-item Patient Health Questionnaire
Numerator includes patients that responded “Don’t know” and “No Response”.
Excludes patients prescribed home health services, as they are ineligible to receive outpatient therapy services; measured at 2-day follow-up call.
Denominator excludes “No Response”
Instrumental social support = having someone to help bathe/dress, etc. for 30 days if assistance is needed; Emotional social support = having a network of family/friends who visit as often as the patient would like.
COMPASS-CP triggered provider to complete Caregiver Assessment