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Associations between Ischemic Stroke Follow-Up, Socioeconomic Status, and Adherence to Secondary Preventive Drugs in Southern Sweden : Observations from the Swedish Stroke Register (Riksstroke)

Ullberg, Teresa LU ; Glader, Eva-Lotta; Zia, Elisabet LU ; Petersson, Jesper LU ; Eriksson, M and Norrving, Bo LU (2017) In Neuroepidemiology 48. p.32-38
Abstract

Background: Currently, the knowledge that one has on adequate stroke follow-up practices is limited. We report associations between 90-day stroke follow-up, socio-economy and adherence to secondary prevention in southern Sweden. Methods: Data on 5,602 patients with ischemic stroke January 1, 2008-December 31, 2010, were obtained from Riksstroke and linked to official registers for information on education, birth country, doctor's follow-ups, and secondary prevention. Primary adherence at 4 months and persistence at 14 months post-stroke were calculated for warfarin, statins, antihypertensive, and antiplatelet drugs. Results: The 90-day follow-up rate was 75%. Patients not receiving a 90-day follow-up had lower age-adjusted OR of... (More)

Background: Currently, the knowledge that one has on adequate stroke follow-up practices is limited. We report associations between 90-day stroke follow-up, socio-economy and adherence to secondary prevention in southern Sweden. Methods: Data on 5,602 patients with ischemic stroke January 1, 2008-December 31, 2010, were obtained from Riksstroke and linked to official registers for information on education, birth country, doctor's follow-ups, and secondary prevention. Primary adherence at 4 months and persistence at 14 months post-stroke were calculated for warfarin, statins, antihypertensive, and antiplatelet drugs. Results: The 90-day follow-up rate was 75%. Patients not receiving a 90-day follow-up had lower age-adjusted OR of persistent drug use at 14 months for antihypertensive agents (OR = 0.74, 95% CI 0.60-0.91) and for antiplatelet drugs (OR = 0.72, 95% CI 0.60-0.87). Drug adherence rates 14 months post-stroke were 85% for antiplatelet drugs, 69% for warfarin, 88% for antihypertensive agents, and 76% for statins. One in three patients discontinued using one or more drug class within 14 months, and nonadherence was associated with activities of daily living dependency at 3 months (age-adjusted OR 0.63, 95% CI 0.57-0.69), but not with age, gender, or educational status. Conclusions: The use of secondary preventive drugs decreases over the first year after stroke and remains suboptimal. Specific reasons for nonadherence warrant further study.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Follow-up, Ischemic stroke, Medication adherence, Secondary prevention, Socio-economic factors
in
Neuroepidemiology
volume
48
pages
7 pages
publisher
Karger
external identifiers
  • scopus:85014075996
  • wos:000403361900004
ISSN
0251-5350
DOI
10.1159/000456618
language
English
LU publication?
yes
id
367bdc6f-02fb-4343-8c04-c7b747744144
date added to LUP
2017-03-13 10:57:57
date last changed
2018-01-07 11:55:04
@article{367bdc6f-02fb-4343-8c04-c7b747744144,
  abstract     = {<p>Background: Currently, the knowledge that one has on adequate stroke follow-up practices is limited. We report associations between 90-day stroke follow-up, socio-economy and adherence to secondary prevention in southern Sweden. Methods: Data on 5,602 patients with ischemic stroke January 1, 2008-December 31, 2010, were obtained from Riksstroke and linked to official registers for information on education, birth country, doctor's follow-ups, and secondary prevention. Primary adherence at 4 months and persistence at 14 months post-stroke were calculated for warfarin, statins, antihypertensive, and antiplatelet drugs. Results: The 90-day follow-up rate was 75%. Patients not receiving a 90-day follow-up had lower age-adjusted OR of persistent drug use at 14 months for antihypertensive agents (OR = 0.74, 95% CI 0.60-0.91) and for antiplatelet drugs (OR = 0.72, 95% CI 0.60-0.87). Drug adherence rates 14 months post-stroke were 85% for antiplatelet drugs, 69% for warfarin, 88% for antihypertensive agents, and 76% for statins. One in three patients discontinued using one or more drug class within 14 months, and nonadherence was associated with activities of daily living dependency at 3 months (age-adjusted OR 0.63, 95% CI 0.57-0.69), but not with age, gender, or educational status. Conclusions: The use of secondary preventive drugs decreases over the first year after stroke and remains suboptimal. Specific reasons for nonadherence warrant further study.</p>},
  author       = {Ullberg, Teresa and Glader, Eva-Lotta and Zia, Elisabet and Petersson, Jesper and Eriksson, M and Norrving, Bo},
  issn         = {0251-5350},
  keyword      = {Follow-up,Ischemic stroke,Medication adherence,Secondary prevention,Socio-economic factors},
  language     = {eng},
  month        = {02},
  pages        = {32--38},
  publisher    = {Karger},
  series       = {Neuroepidemiology},
  title        = {Associations between Ischemic Stroke Follow-Up, Socioeconomic Status, and Adherence to Secondary Preventive Drugs in Southern Sweden : Observations from the Swedish Stroke Register (Riksstroke)},
  url          = {http://dx.doi.org/10.1159/000456618},
  volume       = {48},
  year         = {2017},
}