| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Departments of Neurology (Drs. Holloway and Benesch) and Community and Preventive Medicine (Dr. Holloway), University of Rochester School of Medicine and Dentistry, Rochester, NY; and Quality Improvement (S.R. Rush), American Academy of Neurology, St. Paul, MN.
Address correspondence and reprint requests to Dr. Holloway, Department of Neurology, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642.
Many interventions reduce stroke risk. However, the full benefits of these interventions are not realized at current levels of utilization, as nearly all evidence-based or guideline-endorsed stroke prevention services are underused. The cause for such underuse is multifactorial and includes factors relating to both patients and providers, as well as to a health care system that has de-emphasized prevention at the expense of acute, technologically based care. Much like the evidence for stroke interventions themselves, there is a growing literature to support methods of implementing research evidence into clinical practice. There is still much to learn, however, about the effectiveness of interventions aimed at achieving changes in stroke prevention practice or the delivery of stroke prevention care. Nevertheless, there are many opportunities for providers, managed care organizations, and government to close the evidence–practice gap that exists for stroke prevention services. These opportunities exist in both the inpatient and outpatient setting, and depend on the neurologist taking a leading role in emphasizing the critical importance of risk factor identification and modification in all patients at risk for stroke.
Key words: Stroke—Prevention—Risk factors—Health services.
This article has been cited by other articles:
|
|
 |
|
  E. Touze, J. Coste, M. Voicu, J. Kansao, R. Masmoudi, B. Doumenc, P. Durieux, and J.-L. Mas Importance of In-Hospital Initiation of Therapies and Therapeutic Inertia in Secondary Stroke Prevention: IMplementation of Prevention After a Cerebrovascular evenT (IMPACT) Study Stroke, June 1, 2008; 39(6): 1834 - 1843. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. A. Nickman, J. Biskupiak, F. Creekmore, H. Shah, and D. I . Brixner Antiplatelet medication management in patients hospitalized with ischemic stroke Am. J. Health Syst. Pharm., November 1, 2007; 64(21): 2250 - 2256. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. L. Katzan, N. V. Dawson, C. L. Thomas, M. E. Votruba, and R. D. Cebul The cost of pneumonia after acute stroke Neurology, May 29, 2007; 68(22): 1938 - 1943. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. A. Levine, C. I. Kiefe, T. K. Houston, J. J. Allison, E. P. McCarthy, and J. Z. Ayanian Younger Stroke Survivors Have Reduced Access to Physician Care and Medications: National Health Interview Survey From Years 1998 to 2002 Arch Neurol, January 1, 2007; 64(1): 37 - 42. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. S.V. Elkind and C. G. Benesch Lowering cholesterol in patients with stroke: Raising the standard Neurology, April 25, 2006; 66(8): 1140 - 1141. [Full Text] [PDF]
|
|
|
|
|
|
B. Ovbiagele, J. L. Saver, H. Bang, L. E. Chambless, A. Nassief, J. Minuk, J. F. Toole, J. R. Crouse, and for the VISP Study Investigators Statin treatment and adherence to national cholesterol guidelines after ischemic stroke Neurology, April 25, 2006; 66(8): 1164 - 1170. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Touze, O. Varenne, G. Chatellier, S. Peyrard, P. M. Rothwell, and J.-L. Mas Risk of Myocardial Infarction and Vascular Death After Transient Ischemic Attack and Ischemic Stroke: A Systematic Review and Meta-Analysis Stroke, December 1, 2005; 36(12): 2748 - 2755. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. S. Kirshner, J. Biller, and A. S. Callahan III Long-Term Therapy to Prevent Stroke J Am Board Fam Med, November 1, 2005; 18(6): 528 - 540. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
The Paul Coverdell Prototype Registries Writing Gr Acute Stroke Care in the US: Results from 4 Pilot Prototypes of the Paul Coverdell National Acute Stroke Registry Stroke, June 1, 2005; 36(6): 1232 - 1240. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Ovbiagele, J. L. Saver, A. Fredieu, S. Suzuki, S. Selco, V. Rajajee, N. McNair, T. Razinia, and C. S. Kidwell In-Hospital Initiation of Secondary Stroke Prevention Therapies Yields High Rates of Adherence at Follow-up Stroke, December 1, 2004; 35(12): 2879 - 2883. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Ovbiagele, J. L. Saver, A. Fredieu, S. Suzuki, N. McNair, A. Dandekar, T. Razinia, and C. S. Kidwell PROTECT: A coordinated stroke treatment program to prevent recurrent thromboembolic events Neurology, October 12, 2004; 63(7): 1217 - 1222. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. K. Kapral, A. Laupacis, S. J. Phillips, F. L. Silver, M. D. Hill, J. Fang, J. Richards, J. V. Tu, and for the Investigators of the Registry of the Canad Stroke Care Delivery in Institutions Participating in the Registry of the Canadian Stroke Network Stroke, July 1, 2004; 35(7): 1756 - 1762. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. J. Gladstone, M. K. Kapral, J. Fang, A. Laupacis, and J. V. Tu Management and outcomes of transient ischemic attacks in Ontario Can. Med. Assoc. J., March 30, 2004; 170(7): 1099 - 1104. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. M. Demaerschalk Evidence-Based Clinical Practice Education in Cerebrovascular Disease Stroke, February 1, 2004; 35(2): 392 - 396. [Full Text] [PDF]
|
|
|
|
|
|
M. S. Mouradian, S. R. Majumdar, A. Senthilselvan, K. Khan, and A. Shuaib How Well Are Hypertension, Hyperlipidemia, Diabetes, and Smoking Managed After a Stroke or Transient Ischemic Attack? Stroke, June 1, 2002; 33(6): 1656 - 1659. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. B. Gorelick Stroke Prevention Therapy Beyond Antithrombotics: Unifying Mechanisms in Ischemic Stroke Pathogenesis and Implications for Therapy: An Invited Review Stroke, March 1, 2002; 33(3): 862 - 875. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W.S. Burgin, L. Staub, W. Chan, PhD;, T.H. Wein, R.A. Felberg, J.C. Grotta, A.M. Demchuk, S.L. Hickenbottom, and L.B. Morgenstern Acute stroke care in non-urban emergency departments Neurology, December 11, 2001; 57(11): 2006 - 2012. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. G. Holloway, B. G. Vickrey, C. Benesch, J. A. Hinchey, J. Bieber, M. D. Hill, and C. Zahn Development of Performance Measures for Acute Ischemic Stroke Editorial Comment Stroke, September 1, 2001; 32(9): 2058 - 2074. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
