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 .
Cluster randomized trial in the general practice research database: 2. Secondary prevention after first stroke (eCRT study): study protocol for a randomized controlled trial
Background The purpose of this research is to develop and evaluate methods for conducting pragmatic cluster r and omized trials in a primary care electronic data base . The proposal describes one application , in a less frequent chronic condition of public health importance , secondary prevention of stroke . A related protocol in antibiotic prescribing was reported previously . Methods / Design The study aims to implement a  cluster r and omized trial ( CRT )  using the electronic patient records of the General Practice Research Data base ( GPRD ) as a sampling frame and data source . The specific objective of the trial is to evaluate the effectiveness of a computer-delivered intervention at enhancing the delivery of stroke secondary prevention in primary care . GPRD family practice s will be allocated to the intervention or usual care . The intervention promotes the use of electronic prompts to support adherence with the recommendations of the UK Intercollegiate Stroke Working Party and NICE guidelines for the secondary prevention of stroke in primary care . Primary outcome measure will be the difference in systolic blood pressure between intervention and control trial arms at 12-month follow-up . Secondary outcomes will be differences in serum cholesterol , prescribing of antihypertensive drugs , statins , and antiplatelet therapy . The intervention will continue for 12 months . Information on the utilization of the decision-support tools will also be analyzed . Discussion The CRT will investigate the effectiveness of using a computer-delivered intervention to reduce the risk of stroke recurrence following a first stroke event . The study will provide method ological guidance on the implementation of CRTs in electronic data bases in primary care . Trial registration Current Controlled Trials IS RCT
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 .