Acute stroke clinical care standard indicators: 5b-Separation on statin, antihypertensive and antithrombotic medications for ischaemic stroke
Identifying and definitional attributes
|Metadata item type:||Indicator|
|Short name:||Indicator 5b-Separation on statin, antihypertensive and antithrombotic medications for ischaemic stroke|
|Registration status:||Health, Candidate 14/03/2017|
Proportion of patients with a final diagnosis of ischaemic stroke prescribed and administered statin, antihypertensive and antithrombotic medications, where not contraindicated, on separation from hospital.
Ischaemic stroke patients should be provided statin, antihypertensive and antithrombotic medications on separation from hospital to ensure optimal outcomes.
Lowering lipid levels (using a statin) is an effective primary and secondary prevention treatment for vascular events, including stroke (The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Investigators 2006).
The use of antiplatelet drugs has been shown to provide a 22% reduction in vascular events (myocardial infarction, stroke or vascular death) in patients with a previous stroke or transient ischaemic attack (TIA) (Antithrombotic Trialists’ Collaboration 2002).
Most antihypertensive drugs have been shown to reduce blood pressure, the recurrence of stroke and cardiovascular events (Lakhan & Sapko 2009).
|Indicator set:||Clinical care standard indicators: acute stroke Health, Candidate 14/03/2017|
|Outcome area:||Minimising risk of another stroke Health, Candidate 14/03/2017|
Collection and usage attributes
Both the numerator and the denominator include patients with a final diagnosis of ischaemic stroke.
The numerator requires evidence of prescription and administration of antihypertensives, statins and antithrombotics prior to separation. Antithrombotic medications include: oral anticoagulants, such as warfarin, apixaban, rivaroxaban or dabigatran; and antiplatelet agents, such as aspirin, clopidogrel and dipyridamole.
Both the numerator and the denominator exclude patients for whom antihypertensives, statins or antithrombotics are contraindicated (where the contraindication is clearly documented). Contraindications may include:
Presented as a percentage.
(Numerator ÷ denominator) x 100
Number of patients with a final diagnosis of ischaemic stroke prescribed and administered statin, antihypertensive and antithrombotic medications on separation from hospital.
Number of patients with a final diagnosis of ischaemic stroke separated from hospital.
|Unit of measure:||Episode|
Source and reference attributes
Australian Commission on Safety and Quality in Health Care
Antithrombotic Trialists’ Collaboration 2002. Collaborative meta‑analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 324(7329):71–86
Lakhan SE & Sapko MT 2009. Blood pressure lowering treatment for preventing stroke recurrence: a systematic review and meta‑analysis. Internal Archives of Medicine 2(1):30
NSF (National Stroke Foundation) 2010. Clinical guidelines for stroke management. Melbourne: NSF
The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Investigators 2006. High-dose atorvastatin after stroke or transient ischemic attack. New England Journal of Medicine 355(6):549–559
|Related metadata references:|
See also Acute stroke clinical care standard indicators: 5a-Separation on antihypertensive medication for haemorrhagic stroke Health, Candidate 14/03/2017