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Improved Prevention of Stroke in Primary Care in Stockholm, Sweden (Förbättrad Prevention av Stroke)

Karolinska Institute logo

Karolinska Institute

Status

Completed

Conditions

TIA
Atrial Fibrillation
Ischemic Stroke
Hemorrhagic Stroke

Treatments

Behavioral: structured collegial feed back

Study type

Interventional

Funder types

Other

Identifiers

NCT01942031
EPN2010/1158-31/2

Details and patient eligibility

About

Stroke is a devastating disease. The acute mortality in Sweden is 20 % and 25 % of all patients relapse. Secondary prevention is proven efficient but observational studies have shown that a number of patients are lost to follow up and do not receive recommended prevention. The aim of the study is to 1) describe, by analyzing register data, the detection rate of patients with hospital diagnosis of stroke, TIA, and atrial fibrillation in the primary care center where they are listed. The analysis is done by sex, age, and socioeconomic status. Furthermore, rate of dispensed prescriptions of secondary preventive drugs are analysed for the identified population. 2) in a randomized controlled study evaluate if collegial feed back and targeted information of secondary prevention to the intervention group can improve the detection rate and the medication of the patients listed at the participating primary care centers.

Full description

All primary care centers in Stockholm County (approximately 200) are randomised to control or intervention (receiving structured feed back on detection rate of stroke/transient ischemic attacks in comparison to hospital discharge registry data. The randomisation is done group wise based on training areas. A data set is presented by different means; 1) in written reports, directly to the head of each primary care center in the intervention group 2)in oral presentation on training sessions for the physicians in each training ares. Measures of detection rates of diagnosis and dispensed prescriptions of secondary preventive drugs are made before start of the project and after one year. The control group, ie the primary care centers not receiving feed back, are measured in the same way and thus provide a control group. The hypothesis being that with visibility of the problem, it is easier to improve care wich is what all health providers aim to do.

Outcome measures is percentage of patients with stroke (ICD code I60, I 61, I63, I64) and transitory ischemic attacks(G45) who are dispensed prescribed secondary preventive medication and death.

Enrollment

204 patients

Sex

All

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Primary care center in Stockholm county

Exclusion criteria

  • localisation outside Stockholm County

Trial design

Primary purpose

Prevention

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

204 participants in 2 patient groups

structured collegial feed back
Experimental group
Description:
Structured feed back and information about stroke to the primary care center, to physicians and head of the center
Treatment:
Behavioral: structured collegial feed back
Control group
No Intervention group
Description:
No structured feed back on stroke prevention. Ordinary educational activities only.

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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