Patient-Centered Research into Outcomes Stroke Patients Prefer and Effectiveness Research: Implementing the patient-driven research paradigm to aid decision making in stroke care

• Published in: The American heart journal 2015-07, Vol.170 (1), p.36-45.e11
• Main Authors: Xian, Ying, MD, PhD, O’Brien, Emily C., PhD, Fonarow, Gregg C., MD, Olson, DaiWai M., RN, PhD, Schwamm, Lee H., MD, Hannah, Deidre, RN, MSN, Lindholm, Brianna, BA, Maisch, Lesley, BA, Lytle, Barbara L., MS, Greiner, Melissa A., MS, Wu, Jingjing, MS, Peterson, Eric D., MD, MPH, Pencina, Michael J., PhD, Hernandez, Adrian F., MD, MHS
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Aged; Aged, 80 and over; Anticoagulants - therapeutic use; Antidepressive Agents - therapeutic use; Cardiovascular; Clinical outcomes; Cohort Studies; Decision Making; Depression - drug therapy; Depression - psychology; Female; Focus groups; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Male; Middle Aged; Mortality; Patient Care Planning; Patient Outcome Assessment; Patient Preference; Patient Satisfaction; Prospective Studies; Quality of Life; Retrospective Studies; Secondary Prevention; Stroke; Stroke - psychology; Stroke - therapy; Treatment Outcome
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/j.ahj.2015.04.008

Background Stroke is common and costly, annually depriving the lives and well-being of 800,000 Americans. Despite demonstrated efficacy in clinical trials, questions remain about the safety and clinical effectiveness of various treatment options given patient characteristics, conditions, preferences, and their desired outcomes. Methods and results The Patient-Centered Research Into Outcomes Stroke Patients Prefer and Effectiveness Research (PROSPER) is a Patient-Centered Outcomes Research Institute–sponsored project designed to help patients, physicians, and other stakeholders make informed decisions regarding stroke care and improve outcomes through patient-centered comparative effectiveness research. The primary outcomes identified and prioritized by stroke patients are “home time” (time spent alive and outside a hospital) and major adverse cardiovascular events. With inputs from stroke patients themselves, a series of comparative safety and effectiveness analyses will be performed across 3 prioritized therapeutic areas identified as important by stroke survivors: oral anticoagulants, statin therapy, and antidepressants. We obtained data from Get With the Guidelines-Stroke linked with Medicare claims and follow-up telephone interviews. Our combined retrospective and prospective research strategy allows the evaluation of the safety and effectiveness of various treatment options and patient-centered longitudinal outcomes. To ensure the rapid translation of findings into clinical practice, results will be disseminated to stroke survivors, caregivers, and health care providers through traditional and social media, including an online decision aid tool. Conclusions PROSPER is a patient-centered outcome research study guided by patients, caregivers, and the broader health care community. By addressing knowledge gaps in treatment uncertainties through comparative effectiveness research, PROSPER has the potential to improve decision making in stroke care and patient outcomes reflecting individual patient preferences, needs, and values.