A comparative study of medication use after stroke in four countries

Clin Neurol Neurosurg. 2016 Sep:148:96-104. doi: 10.1016/j.clineuro.2016.07.007. Epub 2016 Jul 4.

Abstract

Objectives: The use of medication plays an important role in secondary stroke prevention and treatment of post-stroke comorbidities. The Collaborative Evaluation of Rehabilitation in Stroke across Europe (CERISE) was set up to investigate the inpatient stroke rehabilitation process in four centres, each in a different European country: Belgium, Germany, United Kingdom and Switzerland.

Patients and methods: Patients' medication use 5 years post-stroke was compared between countries. Focus was put on cerebrovascular secondary prevention, including (a) adequate antithrombotic treatment, (b) treatment of cardiovascular comorbidities and diabetes, and (c) the use of lipid-lowering drugs; as well as on the treatment of stroke-related disorders such as depression, anxiety and pain.

Results: Medication data were available for 247 patients. Data about depression and anxiety were available for 233.

Conclusion: There were no significant differences between the four centres in antithrombotic treatment and in the treatment of cardiovascular comorbidities and diabetes. However, significantly more patients from the UK were treated with lipid-lowering drugs compared to Belgian patients. Significant differences were also observed between the centres in the prevalence and treatment of depression. More Belgian patients suffered from depression compared to German patients and significantly more Belgian patients took antidepressants than patients in Germany. This was in contrast to the prevalence and treatment of anxiety and pain, for which no significant differences between the centres were seen. Related to pain treatment, it was observed that almost 40% of all patients suffering from pain, used no specific medication.

Keywords: Drug therapy; Rehabilitation; Secondary prevention; Stroke.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Analgesics / therapeutic use*
  • Anticoagulants / therapeutic use*
  • Antidepressive Agents / therapeutic use*
  • Belgium
  • Depression / drug therapy*
  • Depression / etiology
  • Female
  • Follow-Up Studies
  • Germany
  • Humans
  • Hypolipidemic Agents / therapeutic use*
  • Male
  • Middle Aged
  • Pain / drug therapy*
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Prevalence
  • Secondary Prevention / statistics & numerical data*
  • Stroke / complications
  • Stroke / drug therapy*
  • Stroke / prevention & control
  • Switzerland
  • United Kingdom

Substances

  • Analgesics
  • Anticoagulants
  • Antidepressive Agents
  • Hypolipidemic Agents
  • Platelet Aggregation Inhibitors