1 in 4 stroke patients discontinue prescription drugs within 3 months
A quarter of stroke patients discontinue one or more of their prescribed secondary stroke prevention medications within three months of hospitalisation for an acute stroke, finds a study.
Dr. Cheryl D. Bushnell Wake Forest University Health Sciences, Winston-Salem, N.C., and colleagues analysed data from the Adherence Evaluation After Ischemic Stroke-Longitudinal (AVAIL) Registry to measure secondary prevention medication persistence in stroke patients from hospital discharge to three months.
“The assessment of and reasons for non-persistence at three months post-stroke are important because the risk of recurrent stroke is greatest during this period,” said the authors.
The authors studied 2,598 patients 18 years or older who had been admitted to 106 U.S. hospitals with ischemic stroke or transient ischemic attack.
Patients were asked a series of standardized questions regarding their medication use three months after hospital discharge.
Those reporting continued use of a therapy or class of therapies from hospital discharge through three months were described as “persistent.”
Statins reduce risk of stroke, but not suitable for certain patients
Cholesterol-lowering statin drugs can reduce the risk of strokes as well as heart attacks, but Loyola University neurologists have warned that they may not be appropriate for certain categories of patients.
A landmark 2006 study known as SPARCL found that statins reduced the risk of subsequent strokes by 16 percent in patients who have experienced strokes or transient ischemic attacks (mini strokes).
But the Loyola neurologists say this benefit generally applies only to patients who have experienced ischemic strokes, which are caused by blood clots in brain vessels.
And even among ischemic stroke patients, there is a small subgroup that should be placed on statin therapy only “with circumspection,” wrote Dr. Murray Flaster, an associate professor in the departments of Neurology and Neurological Surgery at Loyola University Chicago Stritch School of Medicine, and colleagues.
These patients are those who have had strokes in small blood vessels, have poorly controlled high blood pressure and consume more than one drink of alcohol per day.
The picture is more varied for the 15 percent of stroke patients who have had Hemorrhagic strokes (caused by bleeding on or in the brain).
The authors found that, “of those treated, 75.5 percent were persistent with all the medications prescribed by their physician.”
Additionally, further analysis showed that nearly 20 percent of patients were taking at least half of their prescribed medications, while 3.5 percent of patients were taking none of their medications at three months.
The report will be posted online and will appear in the December print issue of Archives of Neurology, one of the JAMA/Archives journals.
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(ANI)