There were no significant effects of organisational  interventions on lipid profile , HbA1c , medication adherence or recurrent cardiovascular events .
Pooled results indicated that educational interventions were not associated with clear differences in any of the review outcomes .
The estimated effects of organisational interventions were compatible with improvements and no differences in several modifiable risk factors .
BACKGROUND People with stroke or transient ischaemic attack ( TIA ) are at increased risk of future stroke and other cardiovascular events .
Evidence -based strategies for secondary stroke prevention have been established .
However , the implementation of prevention strategies could be improved .
OBJECTIVES To assess the effects of stroke service interventions for implementing secondary stroke prevention strategies on modifiable risk factor control , including patient adherence to prescribed medications , and the occurrence of secondary cardiovascular events .
Randomized, Controlled Trial of an Intervention to Enable Stroke Survivors Throughout the Los Angeles County Safety Net to “Stay With the Guidelines”
Background — Stroke is the leading cause of adult disability . Inpatient programs optimize secondary stroke prevention care at the time of hospital discharge , but such care may not be continued after hospital discharge . Methods — To improve the delivery of secondary stroke preventive services after hospital discharge , we have design ed a chronic care model – based program called SUSTAIN ( Systemic Use of STroke Averting INterventions ) . This care intervention includes group clinics , self-management support , report cards , decision support through care guides and protocol s , and coordination of ongoing care . The first specific aim is to test , in a r and omized , controlled trial , whether SUSTAIN improves blood pressure control among an analytic sample of 268 patients with a recent stroke or transient ischemic attack discharged from 4 Los Angeles County public hospitals . Secondary outcomes consist of control of other stroke risk factors , lifestyle habits , medication adherence , patient perceptions of care quality , functional status , and quality of life . A second specific aim is to conduct a cost analysis of SUSTAIN from the perspective of the Los Angeles County Department of Health Services by using direct costs of the intervention , cost equivalents of associated utilization of county system re sources , and cost equivalents of the observed and predicted averted vascular events . Conclusions — If SUSTAIN is effective , we will have the expertise and findings to advocate for its continued support at Los Angeles County hospitals and to disseminate the SUSTAIN program to other setting s serving indigent , minority population s. Clinical Trial Registration — URL : http://www . clinical trials.gov . Unique identifier : NCT00861081
There were no significant effects of organisational  interventions on lipid profile , HbA1c , medication adherence or recurrent cardiovascular events .
Pooled results indicated that educational interventions were not associated with clear differences in any of the review outcomes .
The estimated effects of organisational interventions were compatible with improvements and no differences in several modifiable risk factors .
BACKGROUND People with stroke or transient ischaemic attack ( TIA ) are at increased risk of future stroke and other cardiovascular events .
Evidence -based strategies for secondary stroke prevention have been established .
However , the implementation of prevention strategies could be improved .
OBJECTIVES To assess the effects of stroke service interventions for implementing secondary stroke prevention strategies on modifiable risk factor control , including patient adherence to prescribed medications , and the occurrence of secondary cardiovascular events .