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Published on: December 29, 2023
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Secondary Stroke Prevention in Ontario: A Population-Based Cohort Study.
Jamie L Fleet1,2,3, Moira K Kapral4,5, Brooke Carter2
1Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, Canada.
Summary
Secondary stroke prevention care in Ontario shows suboptimal adherence to guidelines, particularly for laboratory testing. Further research is needed to improve secondary stroke prevention strategies.
Area of Science:
- Neurology
- Public Health
- Epidemiology
Background:
- Secondary stroke prevention is crucial for reducing recurrent vascular events, mortality, and disability.
- Adherence rates to secondary stroke prevention indicators are not well-established.
- This study evaluated secondary stroke prevention care in Ontario, Canada.
Purpose of the Study:
- To assess the adherence to secondary stroke prevention indicators in Ontario, Canada.
- To evaluate laboratory testing, physician visits, and influenza vaccination rates post-stroke.
- To examine medication use in older adults and those with diabetes or atrial fibrillation.
Main Methods:
- Retrospective cohort study using health administrative databases (April 2010-March 2019).
- Included adults discharged alive after an ischemic stroke.
- Evaluated indicators within one year post-stroke, including medication use in specific subgroups.
Main Results:
- Over 54,000 stroke survivors were analyzed.
- Most patients saw a general practitioner within 90 days; 39.6% received influenza vaccination within a year.
- Adherence to lipid-lowering, antihypertensive, antihyperglycemic, and anticoagulant therapies varied, with suboptimal rates for key laboratory testing.
Conclusions:
- Secondary stroke prevention care, particularly laboratory testing, remains suboptimal despite guidelines.
- Barriers to optimal secondary stroke care require further investigation.
- Future research should focus on improving secondary stroke prevention strategies and adherence.
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