Improving Adherence Amongst Post-Stroke Patients in the Outpatient Setting

PURPOSE This quality improvement (QI) project aimed to enhance medication adherence and follow-up rates through structured, personalized phone calls to recently discharged post-stroke patients. The project was implemented at an outpatient neuroscience clinic in Greater Houston. BACKGROUND Low medication adherence and poor attendance at the first neurology follow-up appointment among post-stroke patients contribute to increased morbidity and higher risk of recurrent stroke. Despite receiving discharge instructions, many patients do not consistently take their prescribed medications or attend their initial neurology visit. METHODOLOGY Guided by the Plan-Do-Study-Act (PDSA) cycle, this project engaged a medical assistant to call recently discharged stroke patients to reinforce medication adherence, remind them of their neurology appointment, and address potential barriers. Self-reported adherence was assessed using the Modified Morisky Adherence Scale, and appointment attendance was verified via the electronic medical record. RESULTS Results showed improved medication adherence and follow-up attendance among patients who received the call. Four of five participants reported increased adherence post-intervention, while one maintained high adherence. Four participants also attended their scheduled follow-up. Additionally, 80% stated the call supported their recovery. IMPLICATIONS Personalized follow-up calls helped close critical gaps in post-stroke care by reinforcing adherence and appointment attendance. Incorporating structured communication into routine practice may enhance patient engagement and reduce stroke recurrence. However, the small sample size and brief implementation period limited the ability to assess long-term outcomes. Future projects should extend the intervention timeline and include larger samples to better evaluate sustainability and broader impact.