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Improved Prevention of Stroke in Primary Care in Stockholm, Sweden (Förbättrad Prevention av Stroke)

The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years.
Verified September 2013 by Karolinska Institutet.
Recruitment status was:  Enrolling by invitation
Information provided by (Responsible Party):
Mia von Euler, Karolinska Institutet Identifier:
First received: April 15, 2013
Last updated: September 10, 2013
Last verified: September 2013
Stroke is a devastating disease. The acute mortality in Sweden is 20 % and 25 % of all patients relapse. Secondary prevention is proven efficient but observational studies have shown that a number of patients are lost to follow up and do not receive recommended prevention. The aim of the study is to 1) describe, by analyzing register data, the detection rate of patients with hospital diagnosis of stroke, TIA, and atrial fibrillation in the primary care center where they are listed. The analysis is done by sex, age, and socioeconomic status. Furthermore, rate of dispensed prescriptions of secondary preventive drugs are analysed for the identified population. 2) in a randomized controlled study evaluate if collegial feed back and targeted information of secondary prevention to the intervention group can improve the detection rate and the medication of the patients listed at the participating primary care centers.

Condition Intervention
Ischemic Stroke
Hemorrhagic Stroke
Atrial Fibrillation
Behavioral: structured collegial feed back

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Prevention
Official Title: An Interventional Study of How Collegial Feed Back to Primary Care Physicians on Detection of Diagnosis and Dispensation of Prescribed Secondary Preventive Drugs Affect Stroke Prevention.

Resource links provided by NLM:

Further study details as provided by Karolinska Institutet:

Primary Outcome Measures:
  • percentage of identified patients with stroke/TIA in primary care and analysis of dispensed prescriptions in each group [ Time Frame: Outcome meassures will be followed during two years ]
    percentage of patients identified with hospital discharge diagnosis of stroke/TIA in primary care diagnosis register. Analysis of changes in outcome before intervention and after. the intervention will take place during one year and collection of data before start of intervention and one year after ended intervention will be performed

Secondary Outcome Measures:
  • dispensed prescriptions of secondary preventives drugs in patients with stroke/TIA [ Time Frame: baseline 2010 and 2012, followed for one year after intervention ]
    dispensed prescriptions of recommended secondary preventive drugs in patients detected and not detected at each primary care center

Estimated Enrollment: 200
Study Start Date: October 2013
Estimated Study Completion Date: October 2015
Estimated Primary Completion Date: October 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: structured collegial feed back
Structured feed back and information about stroke to the primary care center, to physicians and head of the center
Behavioral: structured collegial feed back
Collegial feed back to primary care physicians at randomized primary care centers
No Intervention: Control group
No structured feed back on stroke prevention. Ordinary educational activities only.

Detailed Description:

All primary care centers in Stockholm County (approximately 200) are randomised to control or intervention (receiving structured feed back on detection rate of stroke/transient ischemic attacks in comparison to hospital discharge registry data. The randomisation is done group wise based on training areas. A data set is presented by different means; 1) in written reports, directly to the head of each primary care center in the intervention group 2)in oral presentation on training sessions for the physicians in each training ares. Measures of detection rates of diagnosis and dispensed prescriptions of secondary preventive drugs are made before start of the project and after one year. The control group, ie the primary care centers not receiving feed back, are measured in the same way and thus provide a control group. The hypothesis being that with visibility of the problem, it is easier to improve care wich is what all health providers aim to do.

Outcome measures is percentage of patients with stroke (ICD code I60, I 61, I63, I64) and transitory ischemic attacks(G45) who are dispensed prescribed secondary preventive medication and death.


Ages Eligible for Study:   Child, Adult, Senior
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Primary care center in Stockholm county

Exclusion Criteria:

  • localisation outside Stockholm County
  Contacts and Locations
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Please refer to this study by its identifier: NCT01942031

Karolinska Institutet Stroke Research Network at Södersjukhuset
Stockholm, Sweden
Sponsors and Collaborators
Karolinska Institutet
Principal Investigator: Mia von Euler, MD, PhD Karolinska Institutet
  More Information

Responsible Party: Mia von Euler, Associate Professor, Head Karolinska Institutet Stroke Research Network at Södersjukhuset, Karolinska Institutet Identifier: NCT01942031     History of Changes
Other Study ID Numbers: EPN2010/1158-31/2
Study First Received: April 15, 2013
Last Updated: September 10, 2013

Keywords provided by Karolinska Institutet:
Ischemic stroke
Hemorrhagic stroke
Atrial fibrillation
primary care

Additional relevant MeSH terms:
Atrial Fibrillation
Intracranial Hemorrhages
Cerebrovascular Disorders
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Vascular Diseases
Cardiovascular Diseases
Arrhythmias, Cardiac
Heart Diseases
Pathologic Processes
Hemorrhage processed this record on April 28, 2017