Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia.
School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia.
Med J Aust. 2014 Jul 7;201(1):54-7. doi: 10.5694/mja13.00186.
To examine recent trends in the use of secondary stroke prevention medicines by transient ischaemic attack (TIA) and ischaemic stroke survivors.
DESIGN, SETTING AND PARTICIPANTS: Retrospective observational study of patients aged ≥ 65 years who were hospitalised with a TIA or ischaemic stroke between January 2000 and December 2009. Use of antihypertensive, antithrombotic and lipid-lowering medicines by patients was determined monthly, using claims data from the Australian Government Department of Veterans' Affairs, commencing in January 2003.
Monthly prevalence of use of secondary stroke prevention medicines.
Between 2003 and 2009, small increases in use (less than 2% relative increase annually) were observed for antihypertensive and antithrombotic medicines among 19 019 patients. There was a 9% relative increase in use of lipid-lowering therapy each year. The proportion of patients dispensed all three recommended medicine classes nearly doubled over the 7-year period. By December 2009, about 80% of patients were dispensed an antihypertensive, 75% received an antithrombotic and 60% were dispensed lipid-lowering therapy. Almost half of the population were dispensed all three recommended classes by the end of the study period.
Increased use of secondary stroke prevention medicines was shown in this study, in accordance with national stroke guideline recommendations and initiatives supporting quality use of medicines in Australia. There may be opportunity to further increase use of these medicines among older Australians who have had a TIA or ischaemic stroke.
研究短暂性脑缺血发作（TIA）和缺血性脑卒中幸存者二级预防药物的使用趋势。
设计、地点和参与者：回顾性观察性研究，纳入 2000 年 1 月至 2009 年 12 月期间因 TIA 或缺血性脑卒中住院的年龄≥65 岁的患者。自 2003 年 1 月起，使用澳大利亚退伍军人事务部的索赔数据，每月确定患者使用抗高血压、抗血栓和调脂药物的情况。
二级预防药物的每月使用率。
2003 年至 2009 年间，在 19019 例患者中，抗高血压和抗血栓药物的使用略有增加（每年相对增加不到 2%）。降脂治疗的使用率每年增加 9%。7 年间，三种推荐药物类别的患者用药比例几乎翻了一番。到 2009 年 12 月，约 80%的患者使用了抗高血压药物，75%的患者使用了抗血栓药物，60%的患者使用了调脂治疗。研究结束时，近一半的患者同时使用了这三种推荐的药物类别。
本研究表明，根据国家脑卒中指南建议和支持澳大利亚药物合理使用的举措，二级预防药物的使用有所增加。在经历过 TIA 或缺血性脑卒中的澳大利亚老年人中，可能有机会进一步增加这些药物的使用。
