For Better Adherence Following Stroke, Provide Prescriptions at Discharge

Providing prescriptions when patients are discharged from the hospital after a stroke improves medication adherence, the results of a study suggest.

When stroke patients leave the hospital with a prescription in hand, they are 70% more likely to continue taking those medications 1 year later, according to the results of a study published online on August 22, 2014, in The Journal of Stroke and Cerebrovascular Diseases.

Providing a prescription at discharge improved medication adherence 1 week from discharge as well, regardless of whether patients received medication previously, or were new to therapy.

According to lead author Gustavo Saposnik, MD, patients are more focused on tangible aspects of recovery when they are discharged.

“Patients have other things on their minds after a stroke, and it’s up to us to give them the tools they need to thrive,” Dr. Saposnik said in a press release.

Researchers from St. Michael’s Hospital and the Institute for Clinical Evaluative Sciences in Toronto examined data from 2003 to 2008 from 11 Ontario stroke centers to determine the number of participants who were taking their medications 1 week, 1 year, and 2 years after having a stroke. The study cohort included 6437 participants, with 1126 of those participants filling prescriptions for antihypertensives and lipid-lowering agents within 7 days of discharge.

Adherence 1 year after discharge was higher for participants who received a prescription at discharge compared with those who did not, regardless of whether participants took antihypertensives, lipid-lowering agents, or both. The findings were also similar 2 years after discharge, although participants were only 40% more likely to be taking the medications at the 2-year mark, researchers found.

The risk of having another stroke is greater after a prior stroke or minor stroke, but recurrence risk can be reduced by more than 80% if prevention strategies are used.

Researchers cited several reasons patients might be discharged without a prescription, including the assumption that a family physician will provide the prescription, and that patients might not actually receive the prescriptions that are dictated on their charts.

“The good news is that Ontarians are receiving very good stroke care overall,” Dr. Saposnik said. “But there are still things we can do to help patients receive better quality, long-term care after a stroke. And the first thing on that list is giving each patient a prescription before he or she leaves as part of discharge planning.”