Impact of a pilot intervention to increase physician-patient communication about stroke risk in Indonesia
In Indonesia, where stroke is the leading cause of death, we designed and tested a brief intervention to increase physician-patient conversations about stroke prevention in community health centers. The pilot study used a quasi-experimental design involving repeated cross-sectional data collection over 15 weeks to compare pre- and during-intervention differences within four centers. We conducted exit interviews with 675 patients immediately following their medical appointments to assess whether physicians discussed stroke risks and provided recommendations to modify their risk behaviors. From pre-intervention to during intervention, patients reported more frequent physician recommendations to modify their stroke risk behaviors. We also conducted interviews with eight providers (physicians and nurses) after the intervention to get their feedback on its implementation. This study demonstrated that a brief intervention to motivate physician-patient conversations about stroke prevention may improve these conversations in community health centers. While interventions to reduce risk hold considerable promise for reducing stroke burden, barriers to physician-patient conversations identified through this study need to be addressed.