How Australia Prevents Stroke

Large-scale educational programs can effectively change behaviors that can lead to stroke, according to the results of a recent analysis. Zhixin Liu, PhD, of NPS Medicinewise in Sydney, Australia, and colleagues, conducted the study, which was published in the Journal of the American Heart Association in September, 2016.

In 2009-2010, the Australian government-operated National Prescribing Service (NPS) began a program called the NPS MedicineWise Stroke prevention Program, which, the authors say, “sought to improve antithrombotic prescribing in stroke prevention using dedicated interventions that target general practitioners.” The current study was undertaken to determine the impact of that program.

The program was multifaceted and included mailers, educational programs, audits, and other tools for general practitioners (GPs). More than 8500 GPs participated across Australia, but the current analysis examined the 2688 GPs from the state of New South Wales who took part in the program.

The primary population targeted was that of patients at a high risk of cardiovascular disease (CVD), and the researchers say, “the study focused on aspirin use and first-time stroke prevention.” They go on to describe the outcome measures, saying, “The measureable rate of aspirin initiation was used to assess program impact on prescribing in the study population.”

“Consistent with the core message and goals of the NPS MedicineWise program, we observed an increase of 19.8% in first-time prescribing of aspirin, with an associated decrease of 17.3% in stroke hospitalization for persons aged 45 years and older at high CVD risk,” report the researchers.

Although the study is observational in nature, the researchers say, “It appears that the improved health outcomes captured in this study are attributable to the NPS MedicineWise primary care intervention.” They go on to say that the use of a dynamic patient population, rather than a fixed cohort has several advantages, including enhanced validity, reduced confounders, and increased confidence in the results.

The researchers conclude, “The findings suggest that the provision of evidence-based multifaceted educational programs in primary care can be effective in changing prescriber behavior and positively impacting patient health outcomes.”

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