Several evidence-based strategies are available for post-acute secondary prevention after stroke including blood-pressure control, cholesterol lowering, antiplatelet treatment in arterial stroke etiology and oral anticoagulation in patients with atrial fibrillation. These measures are often not (sufficiently) practiced in routine care because patients underestimate the need of thorough secondary prevention or are not able to follow the given recommendation in long term. In contrast to other disease conditions, no disease management program has been established for patients after stroke or TIA and patient do not receive tailored outpatient care, therefore.
We have developed a support program for better protection of patients against new vascular events (recurrent stroke or myocardial infarction). This program has shown to improve the control of risk factors and medication adherence in a preparative study. Currently, we examine the effectiveness of this support program in a large multicenter randomized study regarding reduction of major vascular events. The study is conducted in Berlin at all Charité campuses or at the Vivantes-Auguste-Viktoria Hospital and outside Berlin in Aarhus/Denmark, Munich and Ludwigshafen. We have included almost 2100 patients in the study and expect the results early 2019.
