Prescription Pattern in the Management of Secondary Prevention of Stroke in Post Stroke Patients

Background: To analyze the drug prescription pattern for secondary prevention of stroke, medication adherence, knowledge and awareness about the disease, direct medical cost involved in the treatment of stroke. Methods: A prospective interventional study was done on ischemic stroke patients for a period of 10 months in the outpatient department of stroke after obtaining ethical clearance. Medical prescriptions of all patients were checked as per the ASA guidelines. Educational interventions were given on lifestyle modifiable risk factors with the aid of booklets on stroke. All the patients were assessed for knowledge on stroke, medication adherence at baseline and post-intervention using validated questionnaires. Direct medical cost for treatment during the study was estimated. Results: The mean age of study patients was 59.69 ± 9.56 years and 67% were males. Disease knowledge, medication adherence improved significantly postintervention (P<0.001). Among the various classes of drugs prescribed for secondary stroke prevention, antihypertensive medications constituted the largest class (81%) followed by antiplatelets and statins (68%). Out of 100 patients 99 were having CHADS2 score ≥2, 67% were prescribed with antithrombotic medications who were having medium to high risk for secondary stroke. The mean medication cost for the treatment of stroke during the study period was 33,077.35 ± 10241.32 Rs. Conclusion: The data procured from this study highlights the importance of prescribing patients with anticoagulants rather than antithrombotic or combination of antithrombotic in those who are at medium to high risk for future strokes. Clinical pharmacist’s contributions can provide better management in secondary prevention of stroke.