From the Research
Approximately 80-90% of patients with minor stroke require follow-up by family medicine in the chronic phase of stroke. After the acute management phase, most minor stroke patients transition to primary care for long-term monitoring and management of risk factors. Family physicians play a crucial role in coordinating care, managing secondary prevention medications (such as antiplatelet therapy like aspirin 81-325mg daily or clopidogrel 75mg daily, statins, antihypertensives, and anticoagulants if indicated), monitoring for post-stroke complications, addressing functional recovery needs, and managing comorbidities. This high percentage reflects the reality that while neurologists typically manage the acute phase and early recovery, the chronic phase of stroke care shifts to family medicine as patients reintegrate into community settings. The exact follow-up schedule should be individualized but generally involves visits every 3-6 months initially, then annually once stable. This approach ensures continuity of care and ongoing risk factor management to prevent recurrent strokes, which is particularly important since even "minor" strokes significantly increase the risk of subsequent cerebrovascular events, as supported by recent studies such as 1 and 2.
Some key points to consider in the management of minor stroke patients in the chronic phase include:
- The use of antiplatelet therapy, such as aspirin or clopidogrel, to reduce the risk of recurrent stroke, as recommended by 3 and 1
- The importance of statin therapy, even in patients with low-density lipoprotein cholesterol levels below 70 mg/dL, as shown in 2
- The need for ongoing management of vascular risk factors, such as hypertension, diabetes, and hyperlipidemia, as emphasized in 4 and 5
- The role of lifestyle modifications, including tobacco cessation, decreased alcohol use, and increased physical activity, in reducing the risk of recurrent stroke, as discussed in 5
Overall, the management of minor stroke patients in the chronic phase requires a comprehensive and multidisciplinary approach, with family medicine playing a critical role in ensuring continuity of care and ongoing risk factor management.