Statin Prescription Adhered to Guidelines for Patients Hospitalized due to Acute Ischemic Stroke or Transient Ischemic Attack

BACKGROUND AND PURPOSE: Secondary stroke prevention guidelines recommend statins for the management of dyslipidemia in ischemic stroke and transient ischemic attack (TIA). This study assessed the guideline-based statin prescription (GBSP) rate in Korea and the associated physician and patient factors. METHODS: A survey was conducted to assess Korean neurologists' knowledge of and attitude toward the current dyslipidemia management guidelines. The characteristics and discharge statin prescription for all consecutive patients with acute ischemic stroke or TIA treated by participating neurologists during the 6 months prior to the survey were abstracted. Using algorithms to determine GBSP, we assessed the rate and independent factors of GBSP. RESULTS: Of the 174 participating neurologists, 79 (45.4%) were categorized as a higher-level knowledge group. For the 4407 patients (mean age, 66.4 years; female, 42.5%; 90.6% with ischemic stroke and 9.4% with TIA) enrolled in this study, the GBSP rate at discharge was 78.6%. The GBSP rate increased significantly with increasing physician knowledge level (test for trend, p<0.0001), and was higher among patients treated by the higher-level knowledge group than for those treated by the lower-level knowledge group (81.6% vs. 74.7%; unadjusted p<0.0001 and adjusted p=0.045). Other independent factors associated with a higher GBSP rate were hypercholesterolemia and higher low-density lipoprotein cholesterol level, while those associated with a lower GBSP rate were cardioembolism, undetermined etiology due to negative or incomplete work-up, other determined etiology, and TIA presentation. CONCLUSIONS: More than three-quarters of acute ischemic stroke survivors and TIA patients receive a GBSP at discharge, and this proportion would be further improved by improving the knowledge of dyslipidemia management guidelines among neurologists.

An Effect of the Secondary Stroke Prevention Education Program on Self-care of Acute Ischemic Stroke Patients / 성인간호학회지

PURPOSE: This study was conducted to examine the effects of the secondary stroke prevention education program to inhibit the recurrence of the acute ischemic stroke patients, and to maintain and promote knowledge about stroke, self-efficacy and self-care. METHOD: This study was designed to take a quasi-experimental pre- and post-test with the nonequivalent control group. The experimental group consists of 20 patients and control group consists of 20 patients. The experimental group was applied the secondary stroke prevention education program. In order to verify the effects of the secondary stroke prevention education program, knowledge about stroke, self-efficacy and self-care scale were measured before the intervention and 4 weeks, 12 weeks after discharge. The tools for measuring knowledge about stroke, self-efficacy and self-care are developed by the researcher. The data was analyzed by SPSS win 10.0 program using chi2-test, Fisher's Exact Test, t-test, Kolmogorov- Smirnov Z, and Repeated Measures ANOVA. RESULT: There was a statistically significant difference in knowledge about stroke (F=4.021, p=.026), self-efficacy(F=6.096, p=.018), and self-care(F=8.026, p=.007) between the experimental and the control group after intervention. CONCLUSION: It is considered that the program can be used as an effective nursing intervention in clinical practice.