Intensified Secondary Prevention
The separation of health systems in hospital-based and outpatient care is a major barrier for optimal secondary prevention. Despite the much higher high risk for recurrent cerebrovascular events and other vascular complications, most stroke/TIA patients do not receive more intense monitoring of medical conditions compared to patients in primary prevention.
Programs for supported secondary prevention with improved health education are promising but need to be evaluated.
We have implemented a model of intensified supported secondary prevention and will evaluate this programme in a controlled trial. This will include a prospective randomised trial comparing multifactorial risk factor control and specific antithrombotic treatment in stroke or TIA patients with usual care.