Stroke is an important cause of death and disability. Once you have had a stroke, you have a high chance of having another, but this risk can be reduced by taking stroke prevention medications. Stroke prevention medications include medications to lower cholesterol (statins), blood pressure lowering medications, and medications to reduce the chance of the blood clotting (anti-platelets and anticoagulants). Some patients may be more likely to miss out on stroke prevention medications, for instance patients with additional diseases, patients with mental health problems, and patients who are disabled because of their stroke. We want to investigate which patients are missing out in greater detail.
First, we will describe important characteristics about stroke patients, including their age, any other diseases they have, and any disabilities they have.
Second, we will describe the characteristics that are associated with taking stroke prevention medications in 2017 in a sample of patients who have already had a stroke.
Third, we will examine a sample of patients who had a first stroke between 2006 and 2017 and describe how quickly they started and stopped (if they did stop) taking stroke prevention medications, and identify the factors associated with a greater chance of starting or stopping.
Recurrent strokes account for over 20% of all strokes, yet there is evidence that uptake of stroke prevention medications has stalled in the last ten years, and that certain groups within the stroke survivor population may be missing out on effective prevention treatment, including patients with mental health problems, patients with non-cardiovascular co-morbidities, and patients with increased disability.
The object of this study is to investigate variability in the usage of statins, antihypertensive medications, and anti-platelets or anticoagulants in a stroke survivor population.
First, we will describe key characteristics of the stroke and transient ischaemic attack (TIA) population in July 2017 (prelude to cross-sectional study) and key characteristics of patients experiencing their first stroke or TIA between 2006-2017 (prelude to retrospective cohort study).
Second, we will conduct a cross sectional study which will describe medication usage within the stroke or TIA survivor population in July 2017 and identify factors associated with stroke prevention medication-taking.
Third, a retrospective cohort study will investigate uptake and persistence with medications within patients experiencing their first stroke or TIA between January 2006 and December 2017.
Stroke incidence
- Antihypertensive prescription
- Statin prescription
- Antiplatelet prescription
- Anticoagulant prescription
- Blood pressure <130/80mmHg
Duncan Edwards - Chief Investigator - University of Cambridge
Duncan Edwards - Corresponding Applicant - University of Cambridge
Efthalia (Lina) Massou - Collaborator - University of Cambridge
James Brimicombe - Collaborator - University of Cambridge
Jonathan Mant - Collaborator - University of Cambridge
Zhirong Yang - Collaborator - University of Cambridge
HES Admitted Patient Care;ONS Death Registration Data;Patient Level Index of Multiple Deprivation