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An Assessment of Patients Factors Effect on Prescriber Adherence to Ischemic Stroke Secondary Prevention Guidelines

Majdi Al Qawasmeh1, Ahmed Alhusban2, Firas Alfwaress3

  • 1Department of Neuroscience, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.

Current Reviews in Clinical and Experimental Pharmacology
|January 24, 2020
PubMed

Insights

Physician adherence to stroke secondary prevention guidelines was suboptimal in Jordan, with less than half of patients receiving guideline-adherent prescriptions. This highlights a critical need for improved adherence to reduce stroke recurrence.

Area of Science:

  • Neurology
  • Public Health
  • Clinical Pharmacy

Background:

  • Stroke is a primary cause of long-term disability globally, and stroke recurrence poses a significant health challenge.
  • Adherence to secondary prevention guidelines is crucial for reducing stroke recurrence, yet data from the Middle East and North Africa (MENA) region is scarce.

Purpose of the Study:

  • To evaluate physician adherence to American Stroke Association (ASA) guidelines for secondary stroke prevention.
  • To identify patient-specific factors influencing prescribing patterns in a major Jordanian teaching hospital.

Main Methods:

  • A cohort of 275 ischemic stroke patients discharged from King Abdullah University Hospital was assessed for adherence to secondary prevention guidelines.
  • Prescriptions were evaluated using a composite score, and adherence was classified as adherent or non-adherent.
  • Odds ratios and confidence intervals were calculated to determine factors associated with adherence.

Main Results:

  • Less than 50% of patients received guideline-adherent prescriptions.
  • Patients with hypertension (OR 0.485) and hyperlipidemia (OR 0.225) showed lower adherence rates.
  • Combination therapy with ACE inhibitors/angiotensin receptor blockers (ACEI/ARBs) and thiazides was prescribed to only 11.52% of patients.

Conclusions:

  • Adherence to stroke secondary prevention guidelines, particularly for antihypertensive prescriptions, was suboptimal.
  • Further research and interventions are necessary to enhance adherence to secondary stroke prevention guidelines in this region.
Abstract

Keywords:
Guidelines adherencehypertensionpatient factorsprescribers' attitudesecondary preventionstroke.

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