What are the effects of organizational interventions aimed at improving the implementation of secondary stroke prevention strategies?

Abstract

Compared with usual care for adults after stroke or a transient ischemic attack (TIA), moderate‐certainty evidence shows that multicomponent organizational interventions facilitating or permitting delivery of patient education reduce the number of people who fail to achieve their blood pressure (BP) target (on average, 278 vs 356 per 1000 people). They also appear to lead to reduced low‐density lipoprotein (LDL) cholesterol (on average, by 0.19 mmol/L) and reduced vascular mortality (on average, 10 vs 25 per 1000 people). Results for other outcomes were either imprecise (lipid and HbA1c targets, mean BP levels, incidence of secondary cardiovascular events) or inconsistent (incidences of secondary stroke and TIA), so the impact of organizational interventions remains unclear.