In-hospital initiation of secondary stroke prevention therapies yields high rates of adherence at follow-up.

Abstract:

BACKGROUND AND PURPOSE:The Stroke PROTECT (Preventing Recurrence Of Thromboembolic Events through Coordinated Treatment) program systematically implements, at the time of acute transient ischemic attack (TIA) or ischemic stroke admission, 8 medication/behavioral secondary prevention measures known to improve outcome in patients with cerebrovascular disease. The objective of this study was to determine if the high utilization rates previously demonstrated at hospital discharge were maintained at 90 days after discharge. METHODS:Data were prospectively collected on consecutively encountered ischemic stroke and TIA patients admitted to a university hospital stroke service beginning September 1, 2002. PROTECT interventions were initiated before hospital discharge in all PROTECT-target (underlying stroke mechanism large vessel atherosclerosis or small vessel disease) and PROTECT-ACS (At-risk for Coronary Sequelae) patients. Adherence to program goals was assessed 3 months after discharge. RESULTS:During the period from September 2002 to August 2003, 144 individuals met criteria for PROTECT intervention. Of the 130 patients (90%) with available day 90 follow-up data, mean age was 72 (range, 37 to 95), and 63% were male. Adherence rates in patients without specific contraindications were 100% for antithrombotics, 99% for statins, 92% for angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, and 80% for thiazides. Awareness of the importance of calling 911 in response to stroke was 87%. Adherence to diet and exercise guidelines were 78% and 70%, respectively. Of the 24 smokers, tobacco cessation was maintained in 20 (83%). CONCLUSIONS:High rates of adherence to PROTECT therapies were maintained at 90 days after hospital discharge.

journal_name

Stroke

journal_title

Stroke

authors

Ovbiagele B,Saver JL,Fredieu A,Suzuki S,Selco S,Rajajee V,McNair N,Razinia T,Kidwell CS

doi

10.1161/01.STR.0000147967.49567.d6

subject

Has Abstract

pub_date

2004-12-01 00:00:00

pages

2879-83

issue

12

eissn

0039-2499

issn

1524-4628

pii

01.STR.0000147967.49567.d6

journal_volume

35

pub_type

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