Knowledge of stroke risk factors among primary care patients with previous stroke or TIA: a questionnaire study

Abstract

BackgroundSurvivers of stroke or transient ischaemic attacks (TIA) are at risk of new vascular events. Our objective was to study primary health care patients with stroke/TIA regarding their knowledge about risk factors for having a new event of stroke/TIA, possible associations between patient characteristics and patients' knowledge about risk factors, and patients' knowledge about their preventive treatment for stroke/TIA.MethodsA questionnaire was distributed to 240 patients with stroke/TIA diagnoses, and 182 patients (76%) responded. We asked 13 questions about diseases/conditions and lifestyle factors known to be risk factors and four questions regarding other diseases/conditions ("distractors"). The patients were also asked whether they considered each disease/condition to be one of their own. Additional questions concerned the patients' social and functional status and their drug use. The t-test was used for continuous variables, chi-square test for categorical variables, and a regression model with variables influencing patient knowledge was created.ResultsHypertension, hyperlipidemia and smoking were identified as risk factors by nearly 90% of patients, and atrial fibrillation and diabetes by less than 50%. Few patients considered the distractors as stroke/TIA risk factors (3-6%). Patients with a family history of cardiovascular disease, and patients diagnosed with carotid stenosis, atrial fibrillation or diabetes, knew these were stroke/TIA risk factors to a greater extent than patients without these conditions. Atrial fibrillation or a family history of cardiovascular disease was associated with better knowledge about risk factors, and higher age, cerebral haemorrhage and living alone with poorer knowledge. Only 56% of those taking anticoagulant drugs considered this as intended for prevention, while 48% of those taking platelet aggregation inhibitors thought this was for prevention.ConclusionsKnowledge about hypertension, hyperlipidemia and smoking as risk factors was good, and patients who suffered from atrial fibrillation or carotid stenosis seemed to be well informed about these conditions as risk factors. However, the knowledge level was low regarding diabetes as a risk factor and regarding the use of anticoagulants and platelet aggregation inhibitors for stroke/TIA prevention. Better teaching strategies for stroke/TIA patients should be developed, with special attention focused on diabetic patients.

Poststroke Knowledge and Symptom Awareness: A Global Issue for Secondary Stroke Prevention

“…Eleven studies reported data related to stroke risk factor knowledge among stroke survivors. The most encouraging of these was conducted by Sloma et al [8 ]who found that, when asked ‘How do you think that (risk factor) influences the risk of having a new stroke or TIA? ', approximately 90% of stroke survivors knew that hypertension, hyperlipidemia and smoking increase an individual's risk of stroke.…”

“…They should: (1) be structured and continue over an extended period of time, (2) occur at each stage/level of engagement within the healthcare system, (3) include different delivery formats (e.g. 1-to-1 or a group), (4) emphasize all modifiable risk factors and (5) include information about belief systems [8,30,48,60,61,62,63]. Finally, great care should be taken to ensure that standard information is provided in a uniform and consistent manner across settings and practitioners.…”

“…Poor knowledge of stroke, particularly the risk factors, has been offered as a possible explanation for continuance of an unhealthy lifestyle and poor risk factor management in this population. For example, a study of 182 patients with a history of stroke or TIA by Sloma et al [8] found that less than 50% knew that diabetes was a major risk factor for stroke. This limited knowledge of the impact of diabetes on stroke risk is of concern, as diabetes increases the risk by as much as 10% in people of all ages [9].…”

Prevention and treatment of ischemic stroke in patients with atrial fibrillation

“…AH, hyperlipidemia and tobacco smoking are identified as risk factors of new vascular events by nearly 90% of 182 surviving primary care patients with previous IS or TIA while AF and diabetes mellitus are recognized by less than 50% of these patients (43).…”

İskemik İnmede Risk Faktörleri ve Etkileri

“…İskemik inme veya TİA öyküsü olan hastalarda tekrar inme geçirme riskinin arttığı bilinmektedir (16). Bizim çalışmamızda da geçirilmiş SVH öyküsü; hasta grubunda % 39.2, kontrol grubunda % 5 oranında olup istatiksel olarak anlamlı olarak bulundu (p<0.001).…”