Statin prescription adhered to guidelines for patients hospitalized due to acute ischemic stroke or transient ischemic attack

Keun Sik Hong, Mi Sun Oh, Hye Yeon Choi, A. Hyun Cho, Hyung Min Kwon, Kyung Ho Yu, Hee Joon Bae, Juneyoung Lee, Byung Chul Lee

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)214-222
Number of pages9
JournalJournal of Clinical Neurology (Korea)
Volume9
Issue number4
DOIs
Publication statusPublished - 2013 Oct 10

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Transient Ischemic Attack
Prescriptions
Stroke
Guidelines
Dyslipidemias
Physicians
Knowledge Management
Korea
Secondary Prevention
Hypercholesterolemia
LDL Cholesterol
HDL Cholesterol
Survivors

Keywords

  • Adherence
  • Guideline
  • Ischemic stroke
  • Secondary stroke prevention
  • Statin
  • Transient ischemic attack

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Statin prescription adhered to guidelines for patients hospitalized due to acute ischemic stroke or transient ischemic attack. / Hong, Keun Sik; Sun Oh, Mi; Choi, Hye Yeon; Cho, A. Hyun; Kwon, Hyung Min; Yu, Kyung Ho; Bae, Hee Joon; Lee, Juneyoung; Lee, Byung Chul.

In: Journal of Clinical Neurology (Korea), Vol. 9, No. 4, 10.10.2013, p. 214-222.

Research output: Contribution to journalArticle

Hong, Keun Sik ; Sun Oh, Mi ; Choi, Hye Yeon ; Cho, A. Hyun ; Kwon, Hyung Min ; Yu, Kyung Ho ; Bae, Hee Joon ; Lee, Juneyoung ; Lee, Byung Chul. / Statin prescription adhered to guidelines for patients hospitalized due to acute ischemic stroke or transient ischemic attack. In: Journal of Clinical Neurology (Korea). 2013 ; Vol. 9, No. 4. pp. 214-222.
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abstract = "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.",
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T1 - Statin prescription adhered to guidelines for patients hospitalized due to acute ischemic stroke or transient ischemic attack

AU - Hong, Keun Sik

AU - Sun Oh, Mi

AU - Choi, Hye Yeon

AU - Cho, A. Hyun

AU - Kwon, Hyung Min

AU - Yu, Kyung Ho

AU - Bae, Hee Joon

AU - Lee, Juneyoung

AU - Lee, Byung Chul

PY - 2013/10/10

Y1 - 2013/10/10

N2 - 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.

AB - 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.

KW - Adherence

KW - Guideline

KW - Ischemic stroke

KW - Secondary stroke prevention

KW - Statin

KW - Transient ischemic attack

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