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PROTECT: a coordinated stroke treatment program to prevent recurrent thromboembolic events
B Ovbiagele1, J L Saver, A Fredieu
1Stroke Center and Department of Neurology, UCLA Medical Center, Los Angeles, CA, USA. Ovibes@mednet.ucla.edu
Neurology
|October 13, 2004
Summary
The PROTECT Program significantly improved secondary stroke prevention goal achievement at discharge. This coordinated treatment approach increased medication and lifestyle intervention rates for patients with ischemic stroke or TIA.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Public Health
Background:
- Secondary stroke prevention is crucial for reducing recurrence of thromboembolic events.
- Coordinated, systems-based in-hospital programs can potentially improve adherence to secondary prevention guidelines.
- The Preventing Recurrence of Thromboembolic Events through Coordinated Treatment (PROTECT) Program was implemented to enhance secondary stroke prevention.
Purpose of the Study:
- To evaluate the effectiveness of the PROTECT Program in achieving its secondary prevention goals.
- To assess the impact of the PROTECT Program on treatment utilization at hospital discharge for stroke patients.
Main Methods:
- A comparative study design was used, comparing patients discharged during the PROTECT Program's first year with a historical control group from the preceding year.
- The study included patients diagnosed with ischemic stroke or transient ischemic attack (TIA) admitted to a university hospital-based stroke service.
- Achievement rates for eight secondary prevention goals (medications and lifestyle interventions) at the time of discharge were analyzed.
Main Results:
- Demographics and medical features were comparable between the baseline (n=117) and intervention (n=130) cohorts.
- Significant increases in medication implementation rates were observed: antithrombotic agents (97-100%), statins (68-97%), ACE inhibitors/ARBs (42-90%), and diuretics (14-70%).
- 100% of the intervention cohort received instruction on the program's four lifestyle interventions by discharge.
Conclusions:
- The single-center, systems-based PROTECT Program led to a substantial increase in the utilization of secondary stroke prevention therapies.
- In-hospital implementation of coordinated care significantly improved treatment adherence at the time of hospital discharge.
- The PROTECT Program demonstrates a successful model for enhancing secondary stroke prevention strategies.