scholarly journals The Effects of a Secondary Stroke Prevention Program on the Health Risk Indicators and Self-Care Compliance of Stroke Patients

2016 ◽  
Vol 18 (2) ◽  
pp. 69-77 ◽  
Author(s):  
Ji Yeon Kim ◽  
Yeon Kyung Na ◽  
Hae Sook Hong
Keyword(s):  
Health Risk ◽  
Prevention Program ◽  
Stroke Prevention ◽  
Self Care ◽  
Risk Indicators ◽  
Secondary Stroke Prevention ◽  
Stroke Patients

Self-Care Performance of Middle-Aged Stroke Patients in Korea

2017 ◽  
Vol 28 (3) ◽  
pp. 263-279 ◽  
Author(s):  
Dong Eun Jang ◽  
Juh Hyun Shin
Keyword(s):  
Ischemic Stroke ◽  
Stroke Prevention ◽  
Self Care ◽  
Self Report ◽  
Secondary Stroke Prevention ◽  
Middle Aged ◽  
Stroke Patients ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care Performance

The incidence rate of middle-aged ischemic stroke patients has been increasing. Because of their high risk of recurrence, it is important for them to adhere to their self-care performance. The purpose of this study was to investigate predictors of self-care performance among middle-aged ischemic stroke patients. A descriptive correlational and cross-sectional survey design was used. About 140 participants who had been diagnosed with ischemic stroke within a year and visited neurological outpatients were investigated. Participants answered self-report questionnaires, the Secondary Stroke Prevention Knowledge Scale, the Health-Related Hardiness Scale, and the Subjective Self-Care Performance Scale. Hardiness, secondary-stroke-prevention knowledge, age, and stroke-diagnosis duration had statistically significant influences on self-care performance; hardiness had the largest effect. This study highlighted hardiness as the major predictor of self-care performance. To improve middle-aged ischemic stroke patients’ self-care performance, nurses need an integrated approach that considers a patient’s age, diagnosis duration, secondary-stroke-prevention knowledge, and, especially, hardiness.

Abstract WP97: The Aptamer BT200 Blocks Von Willebrand Factor and Platelet Function in Blood of Stroke Patients

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Katarina Kovacevic ◽  
Stefan Greisenegger ◽  
Nina Buchtele ◽  
Georg Gelbenegger ◽  
Agnes Langer ◽  
...  
Keyword(s):  
Shear Stress ◽  
Acute Stroke ◽  
Platelet Function ◽  
Stroke Prevention ◽  
Large Artery ◽  
Secondary Stroke Prevention ◽  
High Shear ◽  
High Shear Stress ◽  
Stroke Patients ◽  
Blood Samples

Background: The effect of conventional anti-platelet agents is limited in secondary stroke prevention, and their effects are further blunted under conditions of high shear stress in the presence of increased levels of circulating VWF. VWF mediates platelet adhesion to collagen under high shear stress and is thereby critically involved in thrombus formation at sites of stenotic extracranial intracranial arteries (reviewed by Buchtele et al. 2018). We have created a novel anti-VWF aptamer (BT200) which could be useful for secondary stroke prevention, because the anti-VWF aptamer ARC1779 effectively reduced cerebral embolization after carotid endarterectomy (Markus et al. 2011). Aims: To characterize the effects of BT200 in blood of patients with large artery atherosclerosis stroke. Methods: Blood samples were obtained from 30 patients with acute stroke Inhibition of VWF activity by BT200 was quantified by REAADS ELISA and VWF ristocetin cofactor activity (VWF:RCo), platelet function under high shear rates with the PFA-100, and ristocetin-induced platelet aggregation in whole blood. Results: The majority of stroke patients had elevated VWF:RCo levels (mean: 198%; range 55-330%). Of 15 patients receiving clopidogrel with or without aspirin, only two had a prolonged collagen adenosine diphosphate closure time (CADP-CT) >123s, and only one patient had a ristocetin induced aggregation of <20U. BT200 concentration dependently inhibited VWF activity to <3% and VWF dependent platelet function (p<0.001): BT200 invariably prolonged CADP-CT to target levels of >300s, and decreased aggregation to <20U in blood samples from all patients. Conclusions: BT200 effectively inhibits VWF activity and VWF-dependent platelet function in blood from patients with acute stroke. Results from this study proved useful for planning of the ongoing phase I and planned phase II trial.

scholarly journals Factors Affecting Non-Adherence to Secondary Stroke Prevention Therapy in Ischemic Stroke Patients

2018 ◽  
Vol 8 (2) ◽  
pp. 90
Author(s):  
Zakky Cholisoh ◽  
Hidayah Karuniawati ◽  
Tanti Azizah ◽  
Zaenab Zaenab ◽  
Laila Nur Hekmah
Keyword(s):  
Ischemic Stroke ◽  
Secondary Prevention ◽  
Stroke Prevention ◽  
Recurrent Stroke ◽  
Antihypertensive Agents ◽  
Heart Association ◽  
Secondary Stroke Prevention ◽  
Stroke Patients ◽  
Factors Affecting ◽  
Prevention Therapy

Stroke is cardiovascular disease that causes the world's highest disability and is the most prevalence disease after heart disease and cancer. Stroke is caused by circulatory disorders with 80% of the sufferers are diagnosed with ischemic stroke and 20% of them are diagnosed with hemorrhagic stroke. Patients who survive from the first stroke have high risk to have recurrent stroke. American Heart Association/American Stroke Association and Perhimpunan Dokter Spesialis Syaraf Indonesia recommend secondary stroke prevention therapy including antiplatelet/anticoagulant, antihypertensive agents, and antidislipidemia to minimalize the risk of recurrent stroke. Secondary stroke prevention therapy is only the first step. Patients need to be adhere to those therapies. The non-adherence will increase the risk of recurrent stroke. The study aimed to determine factors which causing the non-adherence to secondary prevention therapy in patients with ischemic stroke. This was a case control study with concecutive sampling method by interviewing patients who met the inclusion criterias i.e., had been diagnosed and were inpatients due to ischemic stroke, but in the time of interview patients were outpatients, patients were able to communicate and agree to participate in the study.Data was analized by bivariate / chi square test and multivariate logistic regression test. During the study period, 184 respondents met the inclusion criterias. Factors affecting non-adherence in the use of secondary prevention therapy were No one reminded to take medicine p = 0.03; OR 4.51, denial of the disease p = 0,036 OR 214, and tired of taking medicine p = 0,045 OR 1,97.

scholarly journals Participants’ Perspective of Engaging in a Gym-Based Health Service Delivered Secondary Stroke Prevention Program after TIA or Mild Stroke

2021 ◽  
Vol 18 (21) ◽  
pp. 11448
Author(s):  
Maria Sammut ◽  
Kirsti Haracz ◽  
Coralie English ◽  
David Shakespeare ◽  
Gary Crowfoot ◽  
...  
Keyword(s):  
Health Service ◽  
Prevention Program ◽  
Stroke Prevention ◽  
Recurrent Stroke ◽  
Constructivist Grounded Theory ◽  
Secondary Stroke Prevention ◽  
Structured Interviews ◽  
Community Based ◽  
Mild Stroke ◽  
Ischemic Attack

People who have had a transient ischemic attack (TIA) or mild stroke have a high risk of recurrent stroke. Secondary prevention programs providing support for meeting physical activity recommendations may reduce this risk. Most evidence for the feasibility and effectiveness of secondary stroke prevention arises from programs developed and tested in research institute settings with limited evidence for the acceptability of programs in ‘real world’ community settings. This qualitative descriptive study explored perceptions of participation in a secondary stroke prevention program (delivered by a community-based multidisciplinary health service team within a community gym) by adults with TIA or mild stroke. Data gathered via phone-based semi-structured interviews midway through the program, and at the end of the program, were analyzed using constructivist grounded theory methods. A total of 51 interviews from 30 participants produced two concepts. The first concept, “What it offered me”, describes critical elements that shape participants’ experience of the program. The second concept, “What I got out of it” describes perceived benefits of program participation. Participants perceived that experiences with peers in a health professional-led group program, held within a community-based gym, supported their goal of changing behaviour. Including these elements during the development of health service strategies to reduce recurrent stroke risk may strengthen program acceptability and subsequent effectiveness.

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.

Abstract W P333: Medications for Secondary Stroke Prevention at Hospital Discharge in Da Nang, Viet Nam

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Elizabeth A Cahill ◽  
Thanh G Ton ◽  
Annette L Fitzpatrick ◽  
Kiet A Ly ◽  
Quang V Ngo ◽  
...  
Keyword(s):  
Hospital Discharge ◽  
Stroke Prevention ◽  
Vascular Diseases ◽  
Patient Characteristics ◽  
Older Age ◽  
Viet Nam ◽  
Secondary Stroke Prevention ◽  
Stroke Patients ◽  
Lower Education ◽  
Status Level

Background: Developing countries, such as Viet Nam, are currently undergoing a health transition from infectious to chronic medical conditions, including vascular diseases. Medications for secondary stroke prevention may be underused. Our objectives were to quantify the frequency of such underuse and to identify patient characteristics associated with it. Methods: Data from consecutive patients admitted with stroke to Da Nang Hospital from March 2010 through February 2011 were collected using the WHO Stroke STEPS approach. Patients with ischemic stroke (IS) discharged alive, and not sent home to die, were included. Hypertension (HTN), diabetes mellitus (DM) and hyperlipidemia (HL) were conditions eligible for preventative medications at discharge. "Underuse" was defined as prescribing less than all appropriate medications, given each patient’s conditions. Patients with intraparenchymal hemorrhage were excluded from analyses. Multivariate associations with underuse were assessed for age, gender, number of conditions, stroke symptoms, employment status, level of education, hospital ward, and discharge modified Rankin scale. Results: Of 754 patients admitted with stroke, 260 patients met our inclusion criteria with a mean age of 67.2 years and with 42% women. Most had HTN (91.5%), and some, DM (9.6%) and HL (11.2%). Patients mostly had ≥ 2 conditions needing treatment at discharge (93.5 %). Underuse occurred in 69.2%, with only half being discharged on antithrombotic agents. Factors independently associated with underuse included older age (RR=1.06 per decade; 95% CI: 1.0-1.1), admission to the ward caring for most stroke patients (RR=2.3; 95% CI: 1.5-3.5), and completing only primary school education (RR=1.3; 95% CI: 1.1-1.7). Conclusions: Stroke patients discharged from Da Nang Hospital in Viet Nam are not consistently prescribed medications for secondary stroke prevention. A specific ward, older age, and lower education were independently associated with underuse of preventative medications. Opportunities exist to increase use of medications for secondary stroke prevention at the time of hospital discharge, but barriers will need to be identified.

Abstract TP415: Regular Home Blood Pressure Monitoring Reduces the Risk of Stroke Recurrence

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Wenjun Deng ◽  
David McMullin ◽  
Lindsay Fisher ◽  
Richard Chou ◽  
Jared Jacobson ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Stroke Prevention ◽  
Blood Pressure Monitoring ◽  
Stroke Recurrence ◽  
Secondary Stroke Prevention ◽  
Stroke Patients ◽  
Self Monitoring ◽  
Recurrent Strokes ◽  
At Home

Background: High blood pressure (BP) is a well recognized risk factor for ischemic stroke, and aggressive BP control is critical for secondary stroke prevention. However, hypertensive (HTN) outpatients are often found to have uncontrolled BP, in part due to poor compliance with daily at-home BP monitoring and consequent poor medication adherence. Here, we explore the association of patient home BP self-monitoring compliance with stroke recurrence. Method: Ischemic stroke patients with pre-existing HTN were prospectively recruited in accordance with IRB protocol for this observational study. All patients were trained on BP self-monitoring as per standard of care, and were asked to monitor BP at home daily consistently for 2 weeks. BP monitoring compliance, per completion of BP log, was assessed at each follow-up clinical visit by an investigator blinded to patient outcome. Stroke recurrence was followed for 5 years and independently adjudicated by two vascular neurologists. Result: In a total of 219 patients, only 36 patients (16.4%) were compliant in completing the home BP log as instructed. The compliant and non-compliant groups showed no baseline difference and no medication usage difference (p>0.05) (Table 1). Compliance with at-home BP monitoring was associated with well controlled systolic (p<0.001) and diastolic BP (p<0.001). Of note, 30 patients (16.4%) had recurrent strokes in the non-compliant group, while there were no recurrent strokes in the compliant group. BP self-monitoring compliance is associated with reduced incidence of stroke recurrence (p=0.030) and the significance remains robust after adjusting for multiple confounders (p=0.029) (Table 2). Conclusion: Regular home BP monitoring is associated with lower risk of stroke recurrence in HTN stroke patients. Study in expanded patient cohort is ongoing to leverage technology for better home BP monitoring and to create incentives for compliant behavior for better secondary stroke prevention.

scholarly journals Health Economic Evaluations of Digital Health Interventions for Secondary Prevention in Stroke Patients: A Systematic Review

2019 ◽  
Vol 9 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Alexis  Valenzuela Espinoza ◽  
Stephane Steurbaut ◽  
Alain Dupont ◽  
Pieter Cornu ◽  
Robbert-Jan van Hooff ◽  
...  
Keyword(s):  
Health Economic ◽  
Secondary Prevention ◽  
Stroke Prevention ◽  
Digital Health ◽  
Health Interventions ◽  
Economic Outcomes ◽  
Economic Evaluations ◽  
Secondary Stroke Prevention ◽  
Economic Evidence ◽  
Stroke Patients

Background: In the first 5 years after their stroke, about a quarter of patients will suffer from a recurrent stroke. Digital health interventions facilitating interactions between a caregiver and a patient from a distance are a promising approach to improve patient adherence to lifestyle changes proposed by secondary prevention guidelines. Many of these interventions are not implemented in daily practice, even though efficacy has been shown. One of the reasons can be the lack of clear economic incentives for implementation. We propose to map all health economic evidence regarding digital health interventions for secondary stroke prevention. Summary: We performed a systematic search according to PRISMA-P guidelines and searched on PubMed, Web of Science, Cochrane, and National Institute for Health Research Economic Evaluation Database. Only digital health interventions for secondary prevention in stroke patients were included and all study designs and health economic outcomes were accepted. We combined the terms “Stroke OR Cardiovascular,” “Secondary prevention,” “Digital health interventions,” and “Cost” in one search string using the AND operator. The search performed on April 20, 2017 yielded 163 records of which 26 duplicates were removed. After abstract screening, 20 articles were retained for full-text analysis, of which none reported any health economic evidence that could be included for analysis or discussion. Key Messages: There is a lack of evidence on health economic outcomes on digital health interventions for secondary stroke prevention. Future research in this area should take health economics into consideration when designing a trial and there is a clear need for health economic evidence and models.

scholarly journals The results of implementation of specialized stroke units and educational programs aimed at the secondary prevention of stroke in Tyumen district

2019 ◽  
Vol 18 (1) ◽  
pp. 107-112
Author(s):  
D. I. Lebedeva ◽  
N. S. Brynza ◽  
A. M. Nyamtsu ◽  
Yu. S. Reshetnikova ◽  
N. N. Kniazheva ◽  
...  
Keyword(s):  
Stroke Prevention ◽  
Length Of Hospital Stay ◽  
Target Population ◽  
Educational Programs ◽  
Secondary Stroke Prevention ◽  
Stroke Patients ◽  
Stroke Units ◽  
Number Of Patients ◽  
Target Values ◽  
Systemic Thrombolytic Therapy

Aim. To evaluate the main results of work of specialized stroke units and departments and implementation of educational campaigns on secondary stroke prevention in Tyumen district in 2011-2017.Material and methods. Work efficacy of specialized stroke units and departments in Tyumen district was evaluated according to standard measures (length of hospital stay, compliance with patient routing rules, timely diagnostic measures, frequency and efficacy of thrombolysis). The results of work of schools for stroke patients and their caregivers were evaluated using questionnaires distributed after the end of each educational program.Results. We demonstrated an improvement of main efficacy measures of stroke units and departments, with most of them reaching target values for Russian Federation. There was a high attendance of educational programs on secondary stroke prevention (8254 persons during the study period). A total of 2200 distributed questionnaires demonstrated a high level of satisfaction with the results of educational programs and the quality of education organization.Conclusion. Implementation of specialized stroke units in Tyumen district enabled an increase of the number of patients receiving systemic thrombolytic therapy, a decrease of mortality and an improvement of functional outcomes. Educational programs for stroke patients and their relatives increased the level of stroke awareness in the target population.

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