(141) A Cross-Sectional Observational Study to Assess Treatment Awareness, Prescription Pattern and Adverse Drug Reactions of Secondary Prophylactic Drug Treatment in Patients of Stroke visiting a Tertiary Care Hospital.

Background: Globally, stroke is a leading cause of mortality, witnessing a substantial rise in both incidence and prevalence by 70% and 102% respectively. One in four strokes is recurrent, highlighting the importance of ongoing secondary prophylactic treatment. Lifelong adherence to this treatment is crucial, necessitating heightened patient awareness. The intricate nature of this treatment, involving different drugs from various classes, introduces prescription variability and potential adverse reactions. This study aims to address these concerns with the following objectives.

Objectives: 1. To assess the patient awareness towards secondary prophylactic drug treatment of stroke.
2. To evaluate prescription pattern using WHO indicators and ADRs preceding last 3 months.

Methods: A cross-sectional observational study [IEC(II)/542/2023] was conducted on >18 years old stroke patients attending Neurology OPD in a tertiary care hospital. Drug Treatment awareness was assessed using pre-validated 11 item questionnaire with 5 domains (total score:11 and AVR: 1). Prescription pattern using WHO Indicators and the number of ADRs reported with their causality and severity using WHO UMC Scale and Modified Hartwig Seigel Scale respectively were also assessed. Statistical analysis was done using descriptive statistics and SPSS software version 26.

Results: Among the 360 included patients, the overall drug treatment awareness score was 4.98±2.185, with the least in the "Current Prescription" domain. There was no correlation between the overall awareness score and demographic variables. A total of 1549 drugs were prescribed, 1113 of them in generic names, averaging 3.76 drugs per prescription (3.76±1.52). Total 38 FDCs were prescribed. Of the prescriptions, 206 were incomplete lacking drug-related and lifestyle instructions, dose and duration. The most prescribed drug class was Anti-Platelets, with Aspirin being the predominant choice (36.02%), followed by Statins-Atorvastatin (24.79%). There were 54 reported Adverse Drug Reactions (ADRs), with 39 deemed probable, and the rest possible, and 36 categorized as mild, while the remainder were moderate. Dyspepsia caused by Aspirin was the most common ADR, followed by Pedal Edema attributed to Amlodipine.

Conclusions: Treatment awareness among the patients was sub-optimal indicating the need for patient education programs. Addressing gaps in prescription patterns, such as incomplete prescriptions is imperative for implementing more effective and patient-friendly stroke management strategies. The increased occurrence of ADRs emphasizes the importance of their vigilant monitoring and tailored drug selection, considering individual patient profiles.