Background/Aim:
The National Clinical Guidelines for Stroke Management recommend 21-day dual antiplatelet therapy (DAPT) for patients with minor strokes and long term single antiplatelet therapy (SAPT) for major strokes. To review adherence to antiplatelet therapy recommendations according to guidelines and evaluate written communication of therapy duration to patients and general practitioners on transitions of care at a regional tertiary hospital.
Methods:
HREC approved, retrospective cohort audit of patients admitted with acute ischaemic stroke, conducted between July - December 2024. Patients were identified via the hospital's Stroke Clinical Registry and digital medical records and dispensing software were accessed for data collection. Minor strokes were classified as NIHSS score of 3 or less and moderate/major strokes as a score of greater than 3.
Results:
Overall, 76 patients were included in the study, and 64.5% (49/76) had been identified with minor strokes. All patients were prescribed antiplatelet therapy on discharge. For minor stroke patients, 87.8% (43/49) had been appropriately prescribed DAPT therapy on discharge. Further, 85.7% (42/49) and 81.6% (40/49) of patients with minor stroke had appropriate DAPT duration documented in discharge summary and patients’ medicines lists respectively. For moderate to major stroke patients, only 37% (10/27) had appropriately been prescribed SAPT on discharge.
Conclusion:
Guideline adherence for minor stroke management was high, with clear communication of short-term therapy at transition of care. In contrast, management of major strokes was suboptimal. Further discussion and dissemination of findings with the stroke team are planned to help minimise the risk of patient harm.