Evaluation der Umsetzung der Leitlinien der Deutschen Gesellschaft für Neurologie und der Deutschen Schlaganfallgesellschaft zur medikamentösen Sekundärprävention der zerebralen Ischämie durch Hausärzte

The present study evaluates the implementation of the guidelines for medicamentous secondary prevention of cerebral ischemia created by the German Stroke association and the German Association of Neurology by medical specialists working as general practitioners. Furthermore the study investigates reasons for deviation from the guidelines. For patients who had suffered from a relapse of cerebral ischemia the recommended medicamentous secondary prophylaxis was identified for three groups of medicinal drugs and was compared to the actually taken medication. For this purpose the Essen Risk Score and data of the patients files of the University Hospital of Aachen were used. Possible reasons for an inadequate secondary prophylaxis deviating from the guidelines were collected with the aid of the patients´ files and by using a questionnaire sent to the respective general practitioners. In 83% out of 106 patients secondary prophylaxis was not implemented according to the guidelines in the group „platelet function inhibitors and anticoagulation“, as well as in 33% in the group „statins“ and in 10,4% in the group „antihypertensives“. In total 87,7% of the patients did not receive secondary prophylaxis according to the guidelines in at least one group of drugs. There was no patient with the recommended scheme of „ASS+Dipyridamole“ or „Clopidogrel“, who actually took this medication. Increased patients age, presence of hypertension or cardiovascular events proved to be significant influencing factors in a rising number of medication-groups that were insufficiently regulated. 47,3% of all cases could be explained by insufficient patients compliance (Komma weg) independent of age and gender. In 25,3% (Komma weg) the general practitioner did not see an indication for the recommended medication. Other reasons were mentioned less often. The study shows an insufficient implementation of the guidelines for secondary prevention of cerebral ischemia. Promising approaches to improve the situation are an intensified cooperation between hospitals and general practitioners, ameliorated information and education of (the weg) patients and well-structured prevention programs as well as efforts to improve the guidelines, which should focus much more on the general practitioner, who represents an important instrument in the realization of secondary prevention.

Grantor dc:publisher

Publikationsserver der RWTH Aachen University

Year dc:date

2012

Author dc:creator

• Kühl, Alexandra Anita

Contributors dc:contributor

• Kuth, Nicole

• info:eu-repo/classification/ddc/610
• Schlaganfall
• Sekundärprävention
• Hausarzt
• Thrombozytenaggregationshemmer
• Statine
• Antihypertonikum
• Compliance <Patient>
• Deutsche Gesellschaft für Neurologie
• Ärztliche Behandlung
• Evaluation
• Medizin
• Leitlinien
• zerebrale Ischämie
• guidelines
• secondary prevention
• cerebral ischemia
• compliance
• general practitioner

Statement dc:rights

• info:eu-repo/semantics/openAccess

Language dc:language

ger

Identifier

https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-113405%22

OAI record oai:identifier

https://publications.rwth-aachen.de/oai2d?verb=GetRecord&metadataPrefix=oai_dc&identifier=oai%3Apublications.rwth-aachen.de%3A51088