Andrew Holtz, Senior News Editor for MDiTV, explains why stroke survivors are more at risk of a secondary-stroke if proper medication procedures are ignored. Experts weigh in on this issue to discuss how doctors can better prepare patients for a long road of medical recovery after suffering from a stroke.
Male: On the web and in your hands, this is MDiTV. Andrew Holtz: The crisis strikes; sudden numbness or confusion, speech fails, warning signs of stroke; 911, sirens, ambulance, hospital and the latest knowledge, devices and drugs are deployed to minimize the damage and start the patient toward recover but one stroke means the risk of another is high. Medications can reduce that risk but as the crisis fades into memory, some patients just don’t keep up with their drug refills and so, the benefits of that dramatic medical mobilization at the time of crisis may be undone for one of some pills. The drop-off in medication use can be rapid. The latest documentation comes from Sweden. Within two years after a stroke, the percentage of patients faithfully refilling prescriptions for blood pressure drugs had slipped to 74%. Antiplatelet drug prescriptions were refilled by 63% of patients. Statin use decline to just 56% and less than half of stroke patients, just 45% were still getting Warfarin, a blood thinner fundamental to managing stroke risk. Now, you think that a brush with death would be a great motivator but doctors say there are a number of reasons people fail to keep up with their drug refills. Stroke expert Dr. Bruce Ovbiagele says sometimes the problem is the doctors haven’t done a good job explaining the reason for all those pills. Dr. Bruce Ovbiagele: This is where the fault is ours, the patients are not clear that these medications need to be taken indefinitely. They tend to think sometimes that perhaps the medication is more like an antibiotic where you take it for a period of time and then the condition goes away. But the reality of course, as you well know is that what underlie stroke is really something that is progressive, slowly progressive. So, you really need to take medications regularly to prevent a reoccurrence of a stroke. Andrew Holtz: Another stroke specialist Dr. Helmi Lutsep says in too many cases, the problem is money. Dr. Helmi Lutsep: One of the biggest issues with patients moving away from their care is financial, especially into this economy. Many of the poor patients don’t have insurance and to pay for the medicines and for all the follow-up is a huge issue. They’re again were lucky to have the trials because they often pay even for the medications that the patients are on. Andrew Holtz: Those other stumbling blocks Dr. Lutsep noted may explain some of the drop-off in prescription refills seen in Sweden because after all, Swedes have universal healthcare coverage. The Swedish researchers noted the patients who have multiple health problems seem to do a better job of staying on their medications, perhaps because their checking in with healthcare providers more often. Solid family support also helps and they put it to programs including one at UCLA where Dr. Ovbiagele and his colleagues have shown they can boost the success of long term treatment. Dr. Bruce Ovbiagele: The more organized care is, the more likely patients are to stay on their medication. The more systematic things are, the more likely there could be reminders and props for the patients and not just for the patients but for the doctors as well to make sure their patients stay on their medication. Andrew Holtz: The UCLA stroke team says by educating patients before they leave the hospital and then following up with phone calls and making other efforts, more of those patients stick with their medications and thus reduce the risk, another crisis may strike.