Use of medications for secondary prevention in stroke patients at hospital discharge in Australia

Eissa, Ashraf; Krass, Ines; Bajorek, Beata

doi:10.1007/s11096-013-9908-3

Cited by 13 publications

(14 citation statements)

References 34 publications

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“…Even in hospital-based settings, less than two-thirds of eligible ischemic stroke patients were discharged on all 3 guideline-recommended secondary preventive drugs [37]. Among 858,835 patients with TIA or ischemic stroke, adherence to secondary prevention measures was consistently lower for the TIA cohort [38], suggesting that higher risk patients are more likely to be effectively treated, as we have suggested based on our data.…”

Section: Chd and Stroke Clinical Scenariosmentioning

confidence: 81%

Secondary CV Prevention in South America in a Community Setting: The PURE Study

Avezum

Oliveira

Lanas

et al. 2017

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Section: Chd and Stroke Clinical Scenariosmentioning

confidence: 81%

Secondary CV Prevention in South America in a Community Setting: The PURE Study

Avezum

Oliveira

Lanas

et al. 2017

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“…Considerable non‐adherence for anticoagulation in concurrent atrial fibrillation was evident pre‐MAT implementation. Underprescribing of anticoagulation in stroke patients with atrial fibrillation has been shown in other studies . A significant improvement in anticoagulation in patients with atrial fibrillation was demonstrated post‐implementation of MAT‐CVA.…”

Section: Discussionmentioning

confidence: 52%

“…Underprescribing of anticoagulation in stroke patients with atrial fibrillation has been shown in other studies. [26][27][28][29] A significant improvement in anticoagulation in patients with atrial fibrillation was demonstrated post-implementation of MAT-CVA.…”

Section: Discussionmentioning

confidence: 98%

Clinical pharmacist implementation of a medication assessment tool for secondary prevention of stroke in older persons

Gauci

Wirth

Azzopardi

et al. 2018

J Pharm Health Serv Res

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Objectives Ensuring appropriateness of drug therapy is a key component in the care of older persons and may be supported by medication assessment tools (MATs). The aim of this study was to assess whether implementation of a previously developed MAT for the secondary prevention of ischaemic stroke (MAT‐CVA) in clinical practice contributes to optimisation of drug therapy and clinical pharmacist intervention documentation. Methods Adherence to the criteria in the developed MAT‐CVA was tested by the researcher pre‐MAT implementation by application to 150 patients ≥60 years of age, admitted to a rehabilitation hospital with a diagnosis of ischaemic stroke or transient ischaemic attack. Clinical pharmacists in the hospital were subsequently trained on the use of MAT‐CVA for the purpose of identification of pharmaceutical care issues and intervention within an interdisciplinary healthcare team. Post‐MAT implementation criteria adherence was assessed by the researcher for a further 150 patients with the same inclusion criteria. Key findings MAT‐CVA implementation resulted in significant improvement in the prescription of dipyridamole at the recommended dose in combination with aspirin (z‐score 2.533, P = 0.011) and of anticoagulation in concurrent atrial fibrillation (z‐score 2.468, P = 0.014). Significant improvement was evident in monitoring of liver function following initiation of statin therapy (z‐score 4.017, P < 0.001), in monitoring of serum potassium and renal function with angiotensin‐converting enzyme inhibitors (z‐score 2.632, P = 0.009), and in achievement of blood pressure target (z‐score 3.119, P = 0.002) and HbA1c target (z‐score 5.278, P < 0.001). Clinical pharmacist intervention documentation improved significantly after implementation of MAT‐CVA (z‐score 21.661, P < 0.001). Conclusion Implementation of MAT‐CVA for use by clinical pharmacists within an interdisciplinary healthcare team significantly contributed to optimisation of drug therapy and pharmacist intervention documentation in older persons admitted to a rehabilitation hospital.

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“…The influence of dementia status on initiation of secondary ischemic stroke (IS) prevention has not been addressed on a national scale. In studies to date, dementia was an independent predictor of nontreatment with aspirin or warfarin [9][10][11], while the initiation and/or maintenance of blood-pressure and lipid lowering therapies have been explored only as subanalyses in an underpowered number of dementia patients [12]. The aim of the study was to compare post-discharge secondary stroke prevention and its maintenance up to 3 years after first ischemic stroke in patients with and without dementia.…”

Section: Introductionmentioning

confidence: 99%

Secondary Stroke Prevention After Ischemic Stroke in Patients with Alzheimer’s Disease and Other Dementia Disorders

Županič

Kramberger

Euler

et al. 2020

JAD

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Background: Recurrent ischemic stroke (IS) increases the risk of cognitive decline. To lower the risk of recurrent IS, secondary prevention is essential. Objective: Our aim was to compare post-discharge secondary IS prevention and its maintenance up to 3 years after first IS in patients with and without Alzheimer's disease and other dementia disorders. Methods: Prospective open-cohort study 2007-2014 from the Swedish national dementia registry (SveDem) and the Swedish national stroke registry (Riksstroke). Patients with dementia who experienced an IS (n = 1410; 332 [23.5%] with Alzheimer's disease) were compared with matched non-dementia IS patients (n = 7150). We analyzed antiplatelet, anticoagulant, blood pressure lowering, and statin treatment as planned medication initiation at discharge and actual dispensation of medications at first, second, and third year post-stroke. Results: At discharge, planned initiation of medication was higher in patients with dementia compared to non-dementia patients for antiplatelets (OR with 95% CI for fully adjusted models 1.23 [1.02-1.48]) and lower for blood pressure lowering medication (BPLM; 0.57 [0.49-0.67]), statins (0.57 [0.50-0.66]), and anticoagulants (in patients with atrial fibrillation-AF; 0.41 [0.32-0.53]). When analysis for antiplatelets was stratified according to the presence of AF, ORs for receiving

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Use of medications for secondary prevention in stroke patients at hospital discharge in Australia

Cited by 13 publications

References 34 publications

Secondary CV Prevention in South America in a Community Setting: The PURE Study

Secondary CV Prevention in South America in a Community Setting: The PURE Study

Clinical pharmacist implementation of a medication assessment tool for secondary prevention of stroke in older persons

Secondary Stroke Prevention After Ischemic Stroke in Patients with Alzheimer’s Disease and Other Dementia Disorders

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