Secondary Prevention Three and Six Years after Stroke Using the French National Insurance Healthcare System Database

Eur Neurol. 2018;79(5-6):272-280. doi: 10.1159/000488450. Epub 2018 May 14.

Abstract

Background: Secondary prevention is inadequate in the first 2 years after stroke but what happens after that is less documented. The aim of this study was to assess the use and the adherence to preventive drugs 3 and 6 years after experiencing a transient ischemic attack (TIA) or an ischemic stroke (IS).

Methods: The population study was from the AVC69 cohort (IS or TIA admitted in an emergency or stroke unit in the Rhône area, France, for an IS or a TIA during a 7-month period). Medication use was defined as ≥1 purchase during the studied year and adherence as Continuous Measure of Medication Acquisition ≥0.8 using the French medical insurance health care funding database.

Results: The study population consisted of 210 patients at 3 years and 163 patients at 6 years. Medication use at 3 and 6 years was, respectively, 80.9 and 79.8% for antithrombotics, 69.1 and 66.3% for antihypertensives, 60.5 and 55.2% for statins and 48.6 and 46.6% for optimal treatment defined as the treatment achieved by the use of the 3 drugs. Adherence to each class was good at 3 years and tends to decrease at 6 years.

Conclusions: More than one patient out of 2 do not use the optimal preventive treatment.

Keywords: Antihypertensive agent; Antithrombotic; Medication adherence; Secondary prevention; Statin; Stroke.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents / therapeutic use
  • Cohort Studies
  • Databases, Factual
  • Female
  • Fibrinolytic Agents / therapeutic use
  • France
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Male
  • Middle Aged
  • Patient Compliance / statistics & numerical data*
  • Registries
  • Secondary Prevention / statistics & numerical data*
  • Stroke / prevention & control*

Substances

  • Antihypertensive Agents
  • Fibrinolytic Agents
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors