324 Statin prescribing in ischaemic stroke patients: quality improvement of an acute stroke ward in a model 4 tertiary teaching hospital

Abstract

Abstract Background Stroke remains the leading cause of long-term disability. High cholesterol is associated with increased risk of stroke. Treatment with high intensity statins, as recommended by the SPARCL trial, is effective in reducing recurrence risk. The Medicines Management Programme recommends atorvastatin as the preferred drug, which can be given at any time of the day. With the majority of medications administered in the morning, clustering of medications is associated with higher adherence rates. Low statin adherence is associated with greater risk of death. Methods A point prevalence audit was carried out in an dedicated stroke ward in a tertiary model 4 teaching hospital. The data collected included sex, age, number of days since admission, pre-admission statin administration, current statin prescribed, dose, time of administration and change in current vs pre-admission prescription. Results were collected, analysed and compared with the above evidence. Results 21 inpatients with ischaemic stroke were included. Age ranged from 36 to 89 years, with a mean age of 73. 52% were female. Number of days since admission ranged from 1 to 165, with an average of 48. 13 patients were taking a statin prior to presentation, and 19 at time of data collection. Prescribed statins included atorvastatin and rosuvastatin. 76% had a change in statin type or dose during admission. 95% of patients were prescribed their statin at night time. Conclusion Appropriate statin prescribing is an essential part of secondary prevention. Long acting statin should be prescribed at a time that optimises compliance. We hypothesise that long acting statins including atorvastatin/rosuvastatin when given in the morning with other medications will increase compliancy. In line with the PDSA cycle, a planned education session, in conjunction with the pharmacy department, will take place focusing on atorvastatin/rosuvastatin prescribing, with re-audit following this, to ensure sustained change in practice.