Background: Stroke is the leading cause of long-term disability worldwide. Stroke recurrence
is a major health problem with devastating consequences. Adherence to secondary prevention
guidelines reduced stroke recurrence. Data regarding prescriptions adherence to secondary
prevention guidelines in the Middle East and North Africa is lacking.
Objectives: The aim of this study is to assess the degree of physician adherence to ASA guidelines
and the patient specific factors that affect their prescribing patterns in a major teaching hospital in
Methods: Ischemic stroke patients referring to King Abdullah University Hospital were approached
and offered a description of the study to obtain their informed consent. After getting the informed
consent, their prescription at the time of discharge was evaluated for adherence to secondary prevention
guidelines and classified into adherent and non-adherent based on a composite score that
included each of the guidelines which indicated therapeutic classes. Odds ratio for adherence and
their 95%confidence intervals were calculated and adherence to specific therapeutics classes was
Results: Two hundred and seventy-five patients were included in this evaluation. Less than 50% of
the patients received guideline’s adherent prescriptions. Patients with hypertension and hyperlipidemia
were associated with a lower probability were prescribed a guidelines adherent regimen (OR
0.485, 0.0.225, respectively). ACEI/ARBs combination with thiazides was prescribed to about
11.52% of the patients.
Conclusion: Adherence to stroke secondary prevention guidelines was suboptimal especially in the
antihypertensive prescription component. Further assessments and evaluations are required to improve
Keywords: Guidelines adherence, hypertension, prescribers’ attitude, patient factors, secondary prevention, stroke.
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