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The Pre-Adaptation of a Stroke-Specific Self-Management Program Among Older Adults.

Reistetter T, Hreha K, Dean JM, Pappadis MR, Deer RR, Li CY, Hong I, Na A, Nowakowski S, Shaltoni HM, Bhavnani SK. The Pre-Adaptation of a Stroke-Specific Self-Management Program Among Older Adults. Journal of aging and health. 2023 Oct 1; 35(9):632-642.

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Abstract:

Managing multimorbidity as aging stroke patients is complex; standard self-management programs necessitate adaptations. We used visual analytics to examine complex relationships among aging stroke survivors'' comorbidities. These findings informed pre-adaptation of a component of the Chronic Disease Self-Management Program. Secondary analysis of 2013-2014 Medicare claims with stroke as an index condition, hospital readmission within 90 days ( = 42,938), and 72 comorbidities. Visual analytics identified patient subgroups and co-occurring comorbidities. Guided by the framework for reporting adaptations and modifications to evidence-based interventions, an interdisciplinary team developed vignettes that highlighted multimorbidity to customize the self-management program. There were five significant subgroups ( = 6.19, < .001) of comorbidities such as obesity and cancer. We constructed 6 vignettes based on the 5 subgroups. Aging stroke patients often face substantial disease-management hurdles. We used visual analytics to inform pre-adaptation of a self-management program to fit the needs of older adult stroke survivors.




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