Abstract T P268: Medication Persistence and Risk for Hospital Readmission in Stroke Patients

Background/Objectives: In patients with stroke/TIA, low persistence with hypertension medications increases the risk of stroke recurrence, but there is limited information on medication persistence and readmission. Our aim was to determine whether secondary prevention medication persistence after discharge was associated with readmission at 30 and 90 days in stroke patients. Methods: We enrolled patients discharged home with ischemic (IS) or hemorrhagic stroke (HS) or TIA from October 2012 to February 2014 in the TRAnsition Coaching for Stroke (TRACS). Patients were contacted by telephone between 2 and 30 days for coaching, and 90 days after hospital discharge for outcomes. Medications at discharge were compared to those after discharge by phone or follow-up clinic visit to ascertain stroke prevention medication persistence. Readmission was ascertained using the medical records at the discharge hospital. Statistical tests were performed to assess factors associated with medication persistence and also with all cause and stroke readmission at 30 and 90 days. Results: A total of 142 patients were enrolled (108 IS, 13 HS, and 21 TIA patients); mean age 63.6 ± 13.1 yrs and 52.8% women. Overall medication persistence was 80.3% at 3 months. All cause readmission (ACR) at 30 days was 8.5% (n=12); 4.2% (n=6) due to recurrent stroke/TIA (STR). ACR at 90 days was 18.3% (n=26); 7.0% (n=10) with STR. Multivariate logistic regression model showed that prior hospitalization was associated with ACR at 30 days and CAD, and female sex with ACR at 90 days (Table). Prior stroke was associated with STR at 30 and 90 days (Table). There was a trend toward lower medication persistence (60.0% vs 81.8%, p=0.095) in those with STR at 90 days. Conclusions: In patients discharged with stroke, women and patients with CAD are at risk for ACR and those with prior stroke are at risk for STR, which represents the 3rd event. Poor secondary prevention medication persistence may be a potential risk factor for STR.