Protect

Abstract

Implementation of this single-center, systems-based, in-hospital program to initiate secondary stroke prevention therapies was associated with a substantial increase in treatment utilization at the time of hospital discharge.

Systems approach to standardization of care in the secondary prevention of noncardioembolic ischemic stroke

“…Appropriate prescribing of angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs), statins, and thiazide diuretics was significantly increased from pre-PROTECT levels. 4 After 3 months of follow-up, patient adherence to therapy remained high. 5 The final results of the PROTECT program are not yet available; however, it is reasonable to expect that increased use of evidence-based therapy and good patient adherence to these proven therapies will have led to better patient outcomes, including lower rates of recurrent stroke.…”

“…4 The PRO-TECT program was implemented at a large teaching hospital to improve diagnosis, treatment, and secondary prevention for patients with ischemic stroke. 4 Four medication goals and instruction in 4 lifestyle interventions were chosen as indicators of program impact. In the first year after PRO-TECT was started, 100% of eligible patients received instruction in all 4 areas of lifestyle change prior to discharge.…”

“…In the first year after PRO-TECT was started, 100% of eligible patients received instruction in all 4 areas of lifestyle change prior to discharge. 4 In the year following implementation of PROTECT, the rate of appropriate prescribing of antithrombotics was 98%. Appropriate prescribing of angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs), statins, and thiazide diuretics was significantly increased from pre-PROTECT levels.…”

“…For example, neither study was a prospective, randomized trial with a concurrent control group. 4,6 In addition, PROTECT data were not evaluated by independent audit but by individuals who were aware of the program goals, and limited data were available regarding contraindications to therapy. 4 CHAMP did not assess adherence to nonpharmacologic interventions or the effect of surgical interventions.…”

“…4,6 In addition, PROTECT data were not evaluated by independent audit but by individuals who were aware of the program goals, and limited data were available regarding contraindications to therapy. 4 CHAMP did not assess adherence to nonpharmacologic interventions or the effect of surgical interventions. 6 Large, randomized, controlled trials are needed to better understand the impact of such systems.…”