Mention of PROGRESS therapy in the discharge summary strongly predicted its optimal use at 1 year post-stroke or TIA (OR 10.8; 95% CI 1.3-88.3; P=0.03).
Observational (n=101)
No
Does mentioning PROGRESS therapy in the discharge summary improve adherence to perindopril and indapamide at 1 year in patients with acute stroke or TIA?
Explicitly mentioning secondary prevention antihypertensive therapy in hospital discharge summaries significantly increases the likelihood of patients remaining on optimal treatment at 1 year post-stroke or TIA.
Effect estimate: OR 10.8 (95% CI 1.3-88.3)
p-value: p=0.03
The Perindopril pROtection aGainst REcurrent Stroke Study (PROGRESS) showed the efficacy of blood pressure reduction in secondary stroke prevention. This anti-hypertensive treatment (perindopril 4 mg daily plus indapamide 1.5 mg daily) is now routinely proposed to patients referred to our department for stroke or transient ischaemic attack (TIA). The aim of this study was to evaluate the prescription of PROGRESS therapy during hospitalization and to identify the predictors of therapy discontinuation after discharge. Eligible patients admitted to the Amiens University hospital for acute stroke or TIA from January to April 2003 were included (n = 101). At 1 year, the use of PROGRESS therapy was evaluated by structured phone interviews. In addition, each patient's general practitioner (GP) was also contacted to provide information. PROGRESS therapy was mentioned on the hospital discharge summary significantly less frequently after cardioembolic stroke (OR: 0.15; 95% CI: 0.05-0.5; P = 0.001) and TIA (OR: 0.12; 95% CI: 0.02-0.7; P = 0.02). At 1 year, only 25.7% of patients were treated with optimal PROGRESS therapy (perindopril 4 mg daily plus indapamide 1.5 mg daily). Mention of PROGRESS therapy in the discharge summary was the main predictor of optimal PROGRESS therapy at 1 year (OR: 10.8; 95% CI: 1.3-88.3; P = 0.03). This study shows that mention of PROGRESS therapy in the discharge summary must be improved as it is associated with a higher use of these anti-hypertensive agents 1 year after stroke/TIA.
Bugnicourt et al. (Fri,) conducted a observational in acute stroke or TIA (n=101). PROGRESS therapy (perindopril plus indapamide) was evaluated on Optimal PROGRESS therapy at 1 year (OR 10.8, 95% CI 1.3-88.3, p=0.03). Mention of PROGRESS therapy in the discharge summary strongly predicted its optimal use at 1 year post-stroke or TIA (OR 10.8; 95% CI 1.3-88.3; P=0.03).