Category: Federal Forum Posters
Purpose: After a stroke, effective secondary prevention strategy provides significant gains in the form of reduced disability and mortality. This strategy is the adherence with the clinical guidelines for post-discharge medication prescription. The purpose of this study was to investigate the degree of physician adherence with the international guidelines for post-stroke discharge medications among Lebanese hospitals.
Methods: This was a retrospective observational study conducted at three Lebanese hospitals between January 2016 till December 2017. Adult inpatients with ischemic stroke diagnosis were eligible for study enrollment. Excluded were patients admitted with hemorrhagic stroke. The assessment of physician post discharge prescription pattern adherence with the international guidelines was based upon the prescription antihypertensives, lipid lowering, and antihyperglycemic drugs.
Results: Out of 200 patients with stroke, 64.7% were males. The difference of systolic blood pressure from baseline, 2 hours, and after 24 hours showed significant decrease by mean value 25.18 ±33.45 (P value < 0.001), and 6.44 ± 22.11(P value=0.019) respectively. Also diastolic blood pressure showed significant decrease between baseline and after 24 hours by a mean value 12.17 ±13.63 (P value < 0.001). Concerning post discharge medications adherence, antithrombotic drugs showed the highest percentage (73%) followed by antihypertensive and lipid lowering agents by comparable results (47.5%, 40.7% respectively). The physician adherence for the three medications together showed (30.4%).
Conclusion: Secondary prevention for critical diseases such as stroke appears to be inadequate in the study area. Healthcare professionals need to consider antithrombotics, antihyperglycemics, and antihypertensive therapies for all stroke patients as appropriate.