Abstract P886: Differences in Medication Utilization for Secondary Stroke Prevention Between Ghanaian Stroke Patients and Stroke Patients in the United States

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Esther Olasoji ◽  
FRED S SARFO ◽  
Alexis Simpkins
Keyword(s):  
Risk Factors ◽  
Stroke Prevention ◽  
Stroke Risk ◽  
The United States ◽  
Rural Setting ◽  
Secondary Stroke Prevention ◽  
Stroke Patients ◽  
Stroke Risk Factors ◽  
Medication Utilization ◽  
Oral Agents

Introduction: Optimization of secondary stroke prevention is an essential part of stroke care globally. We sought to assess differences in medication utilization between African Americans (AA), Non-Hispanic Whites (NW), and Ghanaians in addition to effects related to location of residence (rural versus urban). Methods: Data from the UFHealth institutional stroke database and the Kumasi, Ghana Stroke Survivors Registry between 01/2014 and 11/2019 provided a dataset of adult patients diagnosed with stroke from both locations. Multivariate regression analysis identified differences between country of origin, race, patient demographics, location of residence, stroke risk factors, and clinical management following stroke. Results: Of the 5519 patients studied, the median age was 66 (IQR 45 - 87), 16% were AA, 19% Ghanaian, 66% NW, and 51% were male. After controlling for age, sex, stroke type, and stroke risk factors, we found that in comparison to the AA and NW, patients from Ghana were more likely to be prescribed angiotensin converting enzyme (ACE) inhibitors (OR 1.42, 1.05-1.93 95% CI), angiotensin receptor blockers (ARB) (OR 18.36, 13.08-25.78 95% CI), calcium channel blockers (CCB) (OR 8.35, 6.30-11.08 95% CI), statin (OR 3.26, 2.26-4.59 95% CI), anti-diabetic oral agents (OR 7.18, 4.21-12.27 95% CI); less likely to be prescribed anticoagulant (OR 0.22, 0.12-0.40 95% CI), beta blockers (BB) (OR 0.15, 0.11-0.21 95% CI), and insulin (OR 0.11, 0.06-0.20 95% CI). In comparison to AA, Ghanaians were more likely to be prescribed statin (OR 3.06, 1.93-4.86 95% CI), ARBs (OR 22.87, 13.85-37.79 95% CI), CCBs (OR 5.83, 3.94-8.62 95% CI), anti-diabetic oral agents (OR 8.89, 4.25-18.59 95% CI); less likely to live in an urban vs rural setting (OR 0.64, 0.46-0.89 95% CI), be prescribed anticoagulant (OR 0.28, 0.14-0.55 95% CI), BBs (OR 0.13, 0.0.09-0.19 95% CI), and insulin (OR 0.11, 0.05-0.23 95% CI). Conclusion: In conclusion, we found significant differences in the prevalence of medications prescribed for stroke prevention between Ghana and the U.S. Further research is needed to determine if these differences result in consequential differences in stroke reoccurrence between these populations.

A Pharmacist-Led Stroke Education and Screening Program for Community-Dwelling Older Adults

2019 ◽  
Vol 34 (2) ◽  
pp. 127-142
Author(s):  
Marketa Marvanova ◽  
Paul Jacob Henkel
Keyword(s):  
Risk Factors ◽  
Health Status ◽  
Stroke Prevention ◽  
Stroke Risk ◽  
Community Dwelling ◽  
Warning Signs ◽  
Secondary Stroke Prevention ◽  
Stroke Risk Factors ◽  
Stroke Knowledge ◽  
Study Questionnaire

OBJECTIVES: To deliver a pharmacist-led education and screening for community-dwelling residents, assess the effect of this initiative on knowledge of stroke risk factors and warning signs, and evaluate the stroke-knowledge and risk-assessment questionnaire as a tool to identify stroke-related health status and identify need(s) for specific clinical intervention(s) to decrease risk.<br/> DESIGN: The 70-minute-long event comprised: brief introduction/informed consent, baseline assessment of stroke knowledge, completion of study questionnaire, single blood pressure and heart rate readings, presentation, question-and-answer session, postsurvey questionnaire items.<br/> SETTING: Four faith-based institutions in the Midwest.<br/> PARTICIPANTS: Independent community-dwelling adults 18 years of age and older (N = 97), 89.7% 60 years of age and older.<br/> INTERVENTIONS: Thirty-minute presentation followed by question-and-answer session on ischemic stroke. Screening for primary and secondary stroke-prevention status using study questionnaire and vital signs.<br/> MAIN OUTCOME MEASURE(S): Stroke knowledge regarding modifiable stroke-risk factors and acute stroke-warning signs, individual primary/secondary stroke-prevention status.<br/> RESULTS: Postintervention, mean number of modifiable stroke risk factors (2.6 ± 0.8) and warning signs (2.6 ± 0.8) named improved from preintervention (P < 0.001) including for most subgroups (i.e., self-reported hypertension, atrial fibrillation [AF], or high number of personal risk factors). Needs for improved primary/secondary prevention were identified for blood-measure control and antilipidemic therapy. No disparity was observed regarding thrombotic therapy in participants with AF.<br/> CONCLUSION: The program was resource-efficient, involved student pharmacists, improved immediate stroke-related knowledge of participants including those with increased risk(s) of stroke, and demonstrated value for evaluating stroke-related health status and identifying need for primary and secondary stroke prevention.

Abstract P884: Differences in Stroke Type and Stroke Risk Factors Between African Americans and Ghanaian Stroke Patients

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Esther Olasoji ◽  
FRED S SARFO ◽  
Alexis Simpkins
Keyword(s):  
Risk Factors ◽  
African Americans ◽  
Stroke Risk ◽  
Country Of Origin ◽  
Multivariate Regression Analysis ◽  
The United States ◽  
Rural Setting ◽  
Stroke Risk Factors ◽  
Ancestral Lineage ◽  
Stroke Type

Introduction: Ancestral lineage of many African Americans (AA) includes West African descent. Previous research has shown a higher prevalence of cardiovascular risk factors such as hypertension and diabetes mellitus (DM) in AA compared to other racial groups in the United States (US). Some have attributed these differences in the US population to ancestral lineage of the AA population. We sought to compare the stroke type and stroke risk factors between AA and Ghana, a country in West Africa. Methods: Data from the UFHealth institutional stroke database and the Kumasi, Ghana Stroke Survivors Registry between 01/2014 and 11/2019 provided a dataset of adult patients diagnosed with stroke from both locations. Multivariate regression analysis identified differences between country of origin, race, stroke type and clinical factors. Results: Among the 5519 patients, the median age was 66 (IQR 45 - 87), 49% woman, 16% AA, 19% Ghanaian, and 66% non-Hispanic white. In the total population, 22% had an intracerebral hemorrhage, 69% ischemic stroke, and 9% subarachnoid hemorrhage. Compared to patients in the U.S., patients from Ghana were younger (OR 1.06, 1.05-1.06 95% CI); more likely female (OR 1.66, 1.0-1.97 95% CI), hypertensive (OR 8.87, 6.46-12.17 95%CI), and more likely to consume alcohol (OR 4.25, 3.32-5.44 95% CI). Ghanaians were less likely to have DM (OR 0.81, 0.66-0.99 95% CI), smoke (OR 0.10, 0.07-0.13 95% CI), and live in an urban vs rural setting (OR 0.84, 0.71-0.99 95% CI). Compared to AA specifically, Ghanaians were younger (OR 1.02, 1.01-1.03 95% CI); more likely female (OR 1.45, 1.15-1.81 95% CI), hypertensive (OR 4.66, 3.25-6.68 95%CI), more likely to consume alcohol (OR 3.68, 2.62-5.18 95% CI); less likely to have DM (OR 0.55, 0.43-0.71 95% CI), smoke (OR 0.13, 0.08-0.19 95% CI), and less likely live in an urban vs rural setting (OR 0.66, 0.53-0.82 95% CI). Conclusion: Significant differences were found between stroke risk factors (hypertension, DM, alcohol consumption, and smoking) and race as well as country of origin. Further study of social and environmental differences between groups may elucidate the differences in stroke risk factors between AA’s and West Africans.

scholarly journals Hispanic Secondary Stroke Prevention Initiative Design: Study Protocol and Rationale for a Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Olveen Carrasquillo ◽  
BreAnne Young ◽  
Stuti Dang ◽  
Orieta Fontan ◽  
Natalie Ferras ◽  
...  
Keyword(s):  
Risk Factors ◽  
Randomized Controlled Trial ◽  
Stroke Prevention ◽  
Stroke Risk ◽  
Controlled Trial ◽  
Text Messages ◽  
South Florida ◽  
Secondary Stroke Prevention ◽  
Stroke Risk Factors ◽  
Randomized Controlled

BACKGROUND Hispanic-Latino populations face a disproportionate stroke burden and are less likely to have sufficient control over stroke risk factors in comparison with other ethnic populations. A promising approach to improving chronic health outcomes has been the use of community health workers (CHWs). OBJECTIVE The objective of this randomized controlled trial is to evaluate the effectiveness of a CHW intervention among Latino patients at risk of recurrent stroke. METHODS The Hispanic Secondary Stroke Prevention Initiative (HiSSPI) is a randomized clinical trial of 300 Latino participants from South Florida who have experienced a stroke within the last 5 years. Participants randomized into the CHW intervention arm receive health education and assistance with health care navigation and social services through home visits and phone calls. The intervention also includes a mHealth component in which participants also receive daily text messages (short message service). The primary outcome is change in systolic blood pressure at 12 months. Other secondary outcomes include changes in low-density lipoprotein, glycated hemoglobin, and medication adherence. RESULTS Study enrollment began in 2015 and will be completed by the end of 2018. The first results are expected to be submitted for publication in 2020. CONCLUSIONS HiSSPI is one of the first randomized controlled trials to examine CHW-facilitated stroke prevention and will provide rigorous evidence on the impact of CHWs on secondary stroke risk factors among Latino individuals who have had a stroke. CLINICALTRIAL ClinicalTrials.gov NCT02251834; https://clinicaltrials.gov/ct2/show/NCT02251834 (Archived by WebCite at http://www.webcitation.org/72DgMqftq) INTERNATIONAL REGISTERED REPOR RR1-10.2196/11083

Abstract WP328: A Nurse-Led Initiative Improves Adherence Rates for Stroke Follow-up and Blood Pressure Management

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Darren T Larsen ◽  
Helmi L Lutsep
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Stroke Prevention ◽  
Stroke Risk ◽  
Retention Rates ◽  
Matched Cohort ◽  
Stroke Patients ◽  
Stroke Risk Factor ◽  
Chi Square Analysis

Background and Issues Aggressive management of vascular risk factors reduces stroke rates. It is unknown whether structured nurse-led follow up increases adherence rates for stroke patients after hospital discharge. Purpose The purpose of this program is to improve secondary stroke risk factor management by instituting a nurse-led initiative called Stroke Therapy, Education, Prevention (STEP). Methods The pilot STEP program was based on protocols used for other stroke prevention trials. This nurse-led program includes inpatient initiation and outpatient maintenance of pharmacologic and lifestyle goals for stroke patients. Eligible patients have a non-disabling ischemic stroke or TIA and are without insurance restrictions and live within a distance allowing return to clinic for follow up. Prior to discharge, the STEP nurse completes patient education, and reviews outpatient goals. The STEP nurse makes phone contact with the patient 7-10 days after discharge to review medication compliance and reinforce education. At 30 days post discharge patients are seen in clinic by the STEP nurse where a resting blood pressure (BP) is measured. If the patient does not meet targets (<140 SBP or <130 SBP for DM) medications are adjusted by a stroke neurologist. We undertook a retrospective chart review of a consecutive cohort of patients matched to STEP eligibility criteria to determine whether the program improved retention rates and BP management. Chi-Square analysis was used to compare visit adherence and percentage achieving goal BPs at 30 days. Results In the STEP group 25/32(78%) patients completed the 30 day follow up compared to 14/32 (44%) patients in the historical matched cohort (p=0.0048). Target BP was achieved in 13/25(52%) STEP patients and 5/14 (36%) matched cohort patients (p=0.32) returning to clinic. Overall, target BP was achieved in 13/32 (41%) and 5/32 (16%) respectively (p=0.026). Conclusions In conclusion, follow up adherence and BP management in the group as a whole was better in the nurse-led model and is recommended for secondary stroke prevention. Long term follow up with this model may further increase in-target rates of BP control and other stroke risk factors.

Relationship Between Stroke’s Risk Factors with Daily Activities Using Modified Shah Barthel Index in Chronic Stroke Patient at RSCM

2018 ◽  
Vol 24 (8) ◽  
pp. 6225-6231
Author(s):  
S Rachmayanti ◽  
W Kusumaningsih
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Logistic Regression ◽  
Stroke Risk ◽  
Chronic Stroke ◽  
Medical Rehabilitation ◽  
Stroke Patients ◽  
Chi Square ◽  
Stroke Risk Factors ◽  
The Relationship

Hypertension and diabetes mellitus are the most common risk factors of stroke.The study aimed to determine the relationship between stroke risk factors, hypertension and diabetes mellitus, with dependency of chronic stroke patients in Department of Medical Rehabilitation RSCM. The study is conducted by using the analytical observational cross-sectional study. The samples used in this study were 44 respondents selected by quota sampling method. The relationship between variabels was analyzed by bivariate test Chi-Square and multivariate analysis: Logistic Regression. Based on Chi-Square test, relationship between MSBI scoring with hypertension and diabetes mellitus as stroke risk factors, sequentiallly p = 0,122 and p = 0,002. Furthermore, Logistic Regression test suggested that hypertension and diabetes mellitus as stroke risk factors related to MSBI scoring, respectively; hypertension p = 0,076 (OR 4,076; CI95 0,861–19,297) and diabetes mellitus p = 0,007 (OR 22,690; CI95 2,332–220,722). Discussion: Diabetes mellitus is the most prominent risk factor in severe dependecy of chronic stroke patients.

scholarly journals PROFIL FAKTOR-FAKTOR RISIKO PADA PASIEN STROKE YANG DIRAWAT INAP DI IRINA F NEUROLOGI RSUP PROF. Dr. R. D. KANDOU MANADO PERIODE JANUARI – OKTOBER 2012

e-CliniC ◽  
2014 ◽  
Vol 2 (3) ◽  
Author(s):  
Rio Christanto ◽  
Corry N. Mahama ◽  
Melke J. Tumboimbela
Keyword(s):  
Risk Factors ◽  
Stroke Risk ◽  
Risk Category ◽  
Stroke Patients ◽  
Stroke Incidence ◽  
Stroke Risk Factors ◽  
History Of ◽  
Male Sex ◽  
Acute Attacks ◽  
Diabetes Melitus

Abstract: Stroke is a serious neurological disease, with acute attacks that can lead to death. Closely related to the occurrence of stroke risk factors possessed by the patient, especially if there are risk factors that are not addressed properly. Aim: To know the profile of risk factors in stroke patients hospitalized in neurology. irina F  of  RSUP Prof. Dr. R. D. Kandou Manado among period january to october 2012. Methods: The study descriptive with retrospective method is to collect all the data of patients who had been diagnosed with stroke in inpatient neurology irina F RSUP Prof. Dr. R. D. Kandou Manado among period january to october 2012. Results: The results showed that the highest percentage of stroke patients are in the age group 51-65 years (45.2%), male sex (51.2%), high risk category of hypertension (92.2%), risk category Low dyslipidemia ((73.1%), low risk of diabetes mellitus (83.8%), history of heart problems (40.2%), had a history of smoking (8.2%). Conclusion: There are three factors that influence the risk of stroke incidence is age, gender and hypertension Keywords: stroke, risk factors Abstrak: Stroke merupakan penyakit neurologi yang serius, dengan serangan akut yang dapat menyebabkan kematian. Terjadinya stroke berkaitan erat dengan faktor risiko yang dipunyai oleh penderita, terutama bila faktor risiko yang ada tidak ditanggulangi dengan baik. Tujuan: Mengetahui profil faktor-faktor risiko pada pasien stroke yang di rawat inap di irina F neurologi RSUP Prof. Dr. R. D. Kandou Manado periode januari 2012 sampai oktober 2012. Metode: Penelitian deskriktif  dengan metode retrospektif yaitu mengumpulkan semua data penderita yang telah didiagnosa dengan stroke  yang di rawat inap di irina F neurologi RSUP Prof. Dr. R. D. Kandou Manado periode januari 2012 sampai Oktober 2012.  Hasil: Hasil penelitian menunjukan bahwa persentase terbanyak pasien stroke berada pada golongan umur 51-65 tahun (45,2%), berjenis kelamin laki-laki (51,2%), kategori risiko tinggi hipertensi (92,2%), kategori risiko rendah dislipidemia ((73,1%), risiko rendah diabetes melitus (83,8%), riwayat atau kelainan jantung (40,2%), memiliki riwayat merokok (8,2%). Simpulan: Terdapat 3 faktor risiko yang berpengaruh terhadap kejadian stroke yaitu umur, jenis kelamin dan hipertensi Kata kunci: Stroke, faktor risiko

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