Abstract W P348: Evaluating Gaps in the Continuum of Stroke Care
Background and Purpose: Medication adherence is an important factor for secondary stroke prevention in ambulatory care. We aimed to evaluate short-term adherence to antihypertensive and lipid-lowering agents after a new ischemic stroke as a predictor of adherence at one and two years after discharge.
Methods: A five-year cohort (2003-2008) of patients from eleven institutions participating in the Registry of the Canadian Stroke Network (RCSN) was linked to population-based administrative health records. Patients with a diagnosis of an acute ischemic stroke who were discharged home were included in the study. Medication adherence was assessed through documentation of a filled prescription at seven days, one year and two years from hospital discharge.
Results: From 2003 to 2008, 6,437 ischemic stroke patients were discharged home from hospital. A total of 1126 patients filled a prescription for antihypertensive and lipid-lowering agents within 7 days of hospital discharge. Patients provided with a prescription at discharge were more likely to be adherent to antihypertensive and lipid-lowering agents at seven days than patients who did not receive a prescription . Adherence at one year (X% vs Y%, p-value=?) was higher in patients who demonstrated adherence at seven days from discharge for antihypertensive (93.8% vs 87.7%, p<0.0001), lipid-lowering agents (88% vs 81.9%, p<0.0001), or both (85.8% vs 79.9%, p<0.0001). Similar findings are noted at two years for antihypertensives (92.2% vs 87.7%, p=0.0003), lipid-lowering agents (82.6% vs 79.0%, p=0.0394), or both (81.1% vs 77.0%, p=0.0099).
Conclusion: Filling prescriptions within one week of discharge from hospital for acute ischemic stroke predicts adherence for secondary preventive therapies at one and two years. Provision of a prescription at the time of discharge to both prior and new users of anti-hypertensive and lipid-lowering drugs is a simple and effective intervention to improve adherence to secondary preventive medications at seven days, one year and two years after ischemic stroke.
Author Disclosures: J.P. Tsai: None. P.A. Rochon: None. S. Raptis: None. S.E. Bronskill: None. C.M. Bell: None. G. Saposnik: None.
- © 2014 by American Heart Association, Inc.