Quality of medication therapy in patients after stroke depending on presence/absence of diabetes: data from the outpatient stage of REGION-M registry

Abstract

Aim. To assess the quality of medication treatment in the polyclinic within 2 years after discharge, depending on presence/absence of diarecommended for patients with stroke before its development and betes.Material and methods. The study included 684 patients assigned to the City Polyclinic № 64 (Moscow), discharged from F.I. Inozemtsev City Clinical Hospital (Moscow) for a period from January 1, 2012 to April 30, 2017 with a diagnosis of stroke/transient ischemic attack, of which 122 were diagnosed with diabetes.Results. Before stroke, therapy was recommended for 67,3% of patients with diabetes and 54,7% without diabetes (p<0,01): statins — 15,5 and 14,4%, antiplatelet agents — 32,7 and 25,5%, angiotensinconverting enzyme (ACE) inhibitors/angiotensin II receptor blockers (ARBs) — 41,4 and 37,9%, beta-blockers (BBs) — 9,1% and 7,8%, respectively. For the first 6 months after stroke, the rate of statin therapy increased to 39,6 and 39,2%, antiplatelet drugs — to 62,6 and 51,9%, ACE inhibitors/ARBs — to 68,2 and 66%, BBs — to 51,6 and 37,2%, respectively. Then, after 6 months it decreased again to 28,8 and 27,1% for statins, to 30,7 and 35,2% for antiplatelet agents, to 43,3 and 42,6% for ACE inhibitors/ARBs and remained the same for BBs, respectively. There were no significant differences in the prevalence of prescribing most drugs to patients with and without diabetes, both before and after stroke, with the exception of hypoglycemic medications.Conclusion. The therapy of patients with previous stroke, both with and without diabetes, recommended in the polyclinic, is characterized by an insufficient prescription rate of main drug classes necessary for secondary cardiovascular prevention at all follow-up stages.