In-hospital initiation of secondary stroke prevention therapies yields high rates of adherence at follow-up
In-hospital initiation of secondary stroke prevention therapies yields high rates of adherence at follow-up
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DOI：
10.1161/01.str.0000147967.49567.d6
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发表时间：
2004-12-01
期刊：
影响因子：
8.3
通讯作者：
Kidwell, CS
中科院分区：
文献类型：
--
作者：
Ovbiagele, B;Saver, JL;Kidwell, CS
背景和目的——中风保护（通过协调治疗预防血栓栓塞事件复发）计划在急性短暂性脑缺血发作（TIA）或缺血性中风入院时系统地实施8种已知可改善脑血管疾病患者预后的药物/行为二级预防措施。本研究的目的是确定先前在出院时表现出的高利用率是否能在出院后 90 天保持不变。方法 - 前瞻性收集自 2002 年 9 月 1 日开始入院大学医院卒中服务中心的连续遭遇缺血性卒中和 TIA 患者的数据。后遗症）患者。出院后 3 个月对计划目标的遵守情况进行评估。结果 - 从 2002 年 9 月到 2003 年 8 月期间，144 人符合 PROTECT 干预标准。在拥有第 90 天随访数据的 130 名患者 (90%) 中，平均年龄为 72 岁（范围为 37 至 95 岁），其中 63% 为男性。无特定禁忌症的患者对抗血栓药物的依从率为 100%，对他汀类药物的依从率为 99%，对血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂的依从率为 92%，对噻嗪类药物的依从率为 80%。 87% 的人意识到拨打 911 应对中风的重要性。遵守饮食和运动指南的比例分别为 78% 和 70%。在 24 名吸烟者中，有 20 名吸烟者 (83%) 维持戒烟。结论 - 出院后 90 天仍维持较高的 PROTECT 治疗依从率。
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.