Evidence mapPaperPMID 28920085Full record

ArticleeNeurologicalSci2017

Baseline Prescription and One-Year Persistence of Secondary Prevention Drugs after an index Stroke in Central Ghana.

Fred Stephen Sarfo, Bruce Ovbiagele, John Akassi, Gloria Kyem

Abstract read
In one paragraph

Article in eNeurologicalSci, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Observational
  6. Long-Term Outcomes of Stroke in a Ghanaian Outpatient Clinic.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2018
    Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Fred Stephen SarfoKwame Nkrumah University of Science & Technology, Kumasi, Ghana.
Bruce OvbiageleMedical University of South Carolina, USA.
John AkassiKwame Nkrumah University of Science & Technology, Kumasi, Ghana.
Gloria KyemKomfo Anokye Teaching Hospital, Kumasi, Ghana.

Funding

Stroke Investigative Research & Educational Network (SIREN)U54HG007479 · NHGRI · COLLEGE OF MEDICINE, UNIVERSITY OF IBADAN · PI OVBIAGELE, BRUCE, OWOLABI, MAYOWA OJO · 2013 to 2017
$4.2M
Tailored Hospital-based Risk Reduction to Impede Vascular Events after Stroke (THU01NS079179 · NINDS · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI OVBIAGELE, BRUCE · 2012 to 2016
$2.1M
Phone-based Intervention Under Nurse Guidance after Stroke (PINGS)R21NS094033 · NINDS · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI OVBIAGELE, BRUCE · 2015 to 2016
$337k
NHGRI NIH HHS U54 HG007479NINDS NIH HHS R21 NS094033NINDS NIH HHS U01 NS079179
6 · The paper itself

Abstract

background and purposeThere is a paucity of data on persistence of secondary prevention medications among stroke survivors in resource-limited settings where stroke is on a rapid upward trajectory and its management severely challenged. To avert new cardiovascular events after stroke, preventive medications should be promptly instituted and used continuously. We report 1-year rates and determinants of persistent utilization of secondary prevention therapies after stroke in Ghana.

methodsA retrospective observational study involving 418 stroke survivors enrolled into a Neurology clinic in a tertiary institution in central Ghana between January 2011 and December 2013. Data on demography, stroke type, risk factor profile and five secondary risk prevention medication classes namely antihypertensive, antiplatelet, statins, antidiabetic and anticoagulants were collected from patient charts. Persistence within first year after stroke was defined as continuation of all secondary preventive medications prescribed at enrollment to the Neurology clinic and it excluded 126 (≈30%) patients who could not complete 12 month follow up. Data was closed for analysis in June 2015 to allow for at least 12 months of follow-up.

resultsRates of utilization of secondary preventive medications and its intensity were influenced by stroke type and prevailing vascular risk factors. In decreasing order, antihypertensive, lipid-modifying, anti-platelet, anti-diabetic medications and anti-coagulants were prescribed at frequencies (%) of 394 (94.3%), 303 (72.5%), 274 (65.6%), 61 (14.6%) and 2 (0.5%) respectively at enrollment into the Neurology clinic (n=418). Overall, 92.1% of subjects (n=292) under follow-up for 1 year were persistent on secondary prevention medications initiated at enrollment into the neurology clinic with medication class specific rates of 97.5% for antihypertensive, 94.8% for anti-platelets, 94.1% for statins, 85.7% for anti-diabetic and 50% for anticoagulants. Abuse of alcohol was significantly associated with non-persistence, adjusted OR (95% CI) of 3.08 (1.13-8.38).

conclusionPersistence of secondary preventive medications among stroke survivors in this resource-limited setting is excellent and comparable to those in resource-replete countries. There is however the need to investigate the causes of high attrition rates from care.

Identifiers

PMID28920085
PMCPMC5597054

What Socratic holds

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LicenceCC BY-NC-ND
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.