Conclusions Stroke secondary prevention lifestyle interventions are effective in terms of affecting positive change in relation to lifestyle behaviours , physiological and secondary outcomes .
However , there was insufficient evidence to determine the effect of intervention on incidence of stroke recurrence .
EXECUTIVE SUMMARY Background Each year , approximately 15 million people worldwide have a stroke ; of these , five million die and another five million are chronically disabled .
Stroke recurs in approximately 25 % of patients during the first five years post-stroke ; recurrence may result in death , increased disability or institutionalisation .
Modifiable risk factors for recurrent stroke have been identified , and may be addressed by means of behavioural health promotion interventions .
Objectives This systematic review sought to establish the effectiveness of secondary prevention behavioural interventions , which address one or more modifiable lifestyle risk factors for recurrent stroke i.e. tobacco use , unhealthy diet , physical inactivity and excessive alcohol consumption .
Nursing intervention after carotid endarterectomy: a randomized trial of Co-ordinated Care Post-Discharge (CCPD).
AIM This paper reports a study evaluating the short-term impact of nursing-led , co-ordinated care after discharge  following carotid endarterectomy . BACKGROUND Patient education about stroke risk factors , combined systematic ally with carotid endarterectomy , holds unrealized potential to improve patient outcomes . Nurses are well-placed in the healthcare system to co-ordinate this type of education . METHODS A r and omized controlled trial was conducted between October 2001 and October 2002 . Patients having carotid endarterectomy ( n = 133 ) were r and omized to either the intervention ( n = 66 ) or control group ( n = 67 ) . The intervention consisted of telephone liaison with the patient by a Registered Nurse at 2 , 6 and 12 weeks following carotid endarterectomy , combined with education about stroke risk factor management and structured liaison with the patient 's surgeon and referring general practitioner . While patients allocated to the control group did not receive any postoperative telephone contact directly from the Registered Nurse during the study , their general practitioners received structured postoperative liaison . RESULTS The co-ordinated care postdischarge intervention had a statistically significant positive effect on patient knowledge of stroke warning signs ( P = 0.002 ) , patient self-reported changes to improve lifestyle ( P = 0.006 ) and diet modification ( P < 0.001 ) . Statistically significant improvements from baseline to follow-up were detected in both groups for other outcomes . CONCLUSIONS While nursing-led , co-ordinated care after discharge achieves important improvements for short-term outcomes , carotid endarterectomy itself may have been a catalyst for improved patient outcomes . Further research of nursing-led co-ordinated care initiatives for vascular surgery patients is needed
Conclusions Stroke secondary prevention lifestyle interventions are effective in terms of affecting positive change in relation to lifestyle behaviours , physiological and secondary outcomes .
However , there was insufficient evidence to determine the effect of intervention on incidence of stroke recurrence .
EXECUTIVE SUMMARY Background Each year , approximately 15 million people worldwide have a stroke ; of these , five million die and another five million are chronically disabled .
Stroke recurs in approximately 25 % of patients during the first five years post-stroke ; recurrence may result in death , increased disability or institutionalisation .
Modifiable risk factors for recurrent stroke have been identified , and may be addressed by means of behavioural health promotion interventions .
Objectives This systematic review sought to establish the effectiveness of secondary prevention behavioural interventions , which address one or more modifiable lifestyle risk factors for recurrent stroke i.e. tobacco use , unhealthy diet , physical inactivity and excessive alcohol consumption .