Understanding the impact of hospital transition to primary care and follow-up interventions

Survivors of stroke are at increased risk of subsequent vascular events, including recurrent stroke. Pharmacological interventions have been shown to prevent recurrent stroke within this high-risk population. Currently, measurement of adherence to secondary prevention medication are limited to cross-sectional studies at particular point in time from observational and clinical trials data.
Aims: To describe, in a nationally representative, large cohort of stroke survivors (n=25,000), long-term adherence and persistence with medications for secondary prevention; and to identify factors associated with adherence and persistence.
Methods: For the first time in Australia person-level linkages between Australian Stroke Clinical Registry(AuSCR) and Pharmaceutical data will be available. Adherence will be described in terms of non-adherence and poor persistence at 6 months (1-2 years), Patient, clinical, acute care system and community factors associated with adherence will be identified according to optimal care management at hospital discharge and in the community.
Significance: These data will provide essential evidence: to inform practice and policy; target quality improvement activities at the primary care level and develop interventions for improving adherence to secondary prevention medication. Primary health care providers(general practitioners, community pharmacists) and consumers(patients with stroke/TIA and carers) will be involved in the project to ensure results are immediately translatable. Total requested:$49,535