Adherence to secondary stroke prevention strategies - Results from the German stroke data bank

Only very limited data are available concerning patient adherence
to antithrombotic medication intended to prevent a recurrent
stroke. Reduced adherence and compliance could significantly
influence the effects of any stroke prevention strategies. This
study from a large stroke data bank provides representative data
concerning the rate of stroke victims adhering to their recommended
preventive medication. During a 2-year period beginning January 1,
1998, all patients with acute stroke or TIA in 23 neurological
departments with an acute stroke unit were included in the German
Stroke Data Bank. Data were collected prospectively, reviewed,
validated and processed in a central data management unit. Only 12
centers with a follow-up rate of 80% or higher were included in
this evaluation. 3,420 patients were followed up after 3 months,
and 2,640 patients were followed up one year after their stroke.
After one year, 96% of all patients reported still adhere to at
least one medical stroke prevention strategy. Of the patients
receiving aspirin at discharge, 92.6% reported to use that
medication after 3 months and 84% after one year, while 81.6 and
61.6% were the respective figures for clopidogrel, and 85.2 and
77.4% for oral anticoagulation. Most patients who changed
medication switched from aspirin to clopidogrel. Under the
conditions of this observational study, adherence to stroke
prevention strategies is excellent. The highest adherence rate is
noticed for aspirin and oral anticoagulation. After one year, very
few patients stopped taking stroke preventive medication. Copyright
(C) 2003 S. Karger AG, Basel.