From Our 2010 Archives
Stroke Patients Discharged Without Statins
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One in Five Stroke Patients Leave Hospitals Without Prescriptions for Statin Medications
Reviewed By Elizabeth Klodas, MD, FACC
May 27, 2010 -- Far too many stroke patients are being discharged from hospitals without receiving prescriptions for statin medications, a new study shows.
This is alarming because previous studies have shown that patients who take the cholesterol-lowering medications after a stroke reduce their chances of recurrent events, the researchers report.
The study is published in Stroke: Journal of the American Heart Association. It shows that of 173,284 patients in one large database of stroke patients, 83.5% were prescribed statins at the time of their discharge from a hospital. This means that nearly one in five stroke patients don't receive a potentially life-saving medication.
"Approximately one in 10 stroke patients experience another stroke within a week," the study researcher Bruce Ovbiagele, MD, MSc, director of the UCLA Stroke Prevention Program, says in a news release. "The hospital encounter provides a window of opportunity to ensure prompt and appropriate initiation of treatments, such as statins, that could prevent another stroke."
The researchers analyzed data on 173,284 stroke patients who had been hospitalized around the country between January 2005 and December 2007. These patients were listed in the American Heart Association/American Stroke Association's "Get With the Guidelines-Stroke" quality improvement registry.
On the positive side, according to the findings, the rates of statin prescriptions for stroke patients improved steadily from 75.7% to 84.8% during the span of years that was studied. However, this still leaves a lot of patients who are not receiving an important treatment, "which unnecessarily exposes them to the risk of another stroke" the researchers say.
It should be noted that the "Get With the Guidelines-Stroke" program is a voluntary quality improvement registry and the participating hospitals may be particularly motivated to improve care. "As such, our findings may not necessarily be representative of all types of hospitals and it is conceivable that national discharge statin treatment rates after stroke may actually be worse," the researchers write.
Some disparities in statin treatment were noted by the researchers.
"We found that several individual and hospital level factors were linked to not receiving a statin at the time of hospital discharge after a stroke," Ovbiagele says. "For instance, women had 13% lower odds of receiving a statin compared to men, [and] hospitals in the South had 34% lower odds of discharging a stroke patient on a statin compared to hospitals in the West," even though stroke incidence and deaths related to strokes are higher in the South compared to the rest of the country.
Researchers now will need to tackle the question of why treatment disparities exist, and what could be done to solve the problem. "Our results emphasize the need to find better ways of bridging these sex and geographic disparities in stroke care," the researchers write.
The researchers list multiple individual disclosures, including research support from various drug companies, consultation agreements, speakers' bureau fees, and the provision of expert opinions in malpractice lawsuits about stroke prevention and treatment.
SOURCES: News release, American Heart Association.