Current status and developments in the care of stroke patients in Portugal

Introduction: We discuss current status and developments in the care of stroke patients in Portugal. Theory and methods: Stroke is the main cause of death in Portugal and the main cause of disability on elderly people. This situation has raised great concern and several initiatives have been put in place to deal with the problem. The Unidades de Acidentes Vasculares Cerebrais – (UAVC) (Stroke Unit) were launched in 2001, aiming at reducing length of stay in acute care hospitals, functional incapacity and post-stroke complications, the number of patients in need of home nursing or specialized inpatient long-term care, as well as facilitating reintegration in family and society, namely return to workplace. The study is based on deep literature review and clinical experience in specialized care for stroke patients in Portugal. Results: Until the launch of UAVCs, a patient suffering from stroke would be admitted to a Serviço de Neurologia (Neurology Service) or to a Serviço de Medicina Interna (Internal Medicine Service), probably in the hospital closest to the occurrence and care would be oriented to the acute phase. Nowadays, patients with a diagnosis of stroke are preferably directed to a UAVC. These units integrate health professionals especially trained for these situations and apply diagnostic and therapeutic procedures according to protocols that follow the most recent international recommendations. The multidisciplinary teams execute integrated care and rehabilitation plans based on the individual needs. Complementary exams are done systematically aiming at more complete understanding. After discharge, patients are followed up in outpatient specific consultation. One of the most relevant practices adopted is physiotherapy care that promotes early mobilization and get up. Conclusions and discussion: There are about 30 UAVCS in Portugal, some of them still working under technical and human limitations. However, these units are but one of the links in the chain of care. Many attempts have been made to integrate care in Portugal. At least in some areas, much is still to be done in this regard.