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Understanding Secondary Prevention in Stroke Care: Early Detection and Effective Management

Secondary prevention plays a crucial role in stroke care by focusing on the early detection of diseases, even before symptoms appear. Its primary aim is to prevent an initial stroke or recurrent strokes, thus enhancing patient outcomes. The initiative began in 1997 with four pilot sites across Ontario and has evolved into a comprehensive strategy involving 24 Stroke Prevention Clinics (SSPCs). These clinics provide organized risk factor management and rapid access to diagnostic testing, ultimately promoting efficiency and better planning in stroke care.

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Understanding Secondary Prevention in Stroke Care: Early Detection and Effective Management

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  1. HSFO Mid-morning Program

  2. What is secondary prevention? • The early detection of disease, either when it produces symptoms or even before symptoms are noticed. • The goal is to prevent disease from progressing to a completed stroke or to prevent recurrent stroke.

  3. History of SSPCs • Four original pilot sites: South East, West Greater Toronto, Central West, South West (1997) • Conceived as part of the Coordinated Stroke Strategy in Towards An Integrated Stroke Strategy For Ontario(June 2000) • Tailored after the Stroke Prevention Clinic (LHSC) and cardiac MULTIFIT programs (USA)

  4. Part of a continuum of stroke care within district and regional stroke centres • “Offer comprehensive, cost-efficient, organized and expert risk factor management … to high-risk patients” • Hospital-based to facilitate rapid access to diagnostic testing • Currently 24 SSPCs

  5. Team SPIRIT • Stroke Performance Indicators for Reporting, Improvement and Translation • Joint initiative of the Canadian Stroke Network and the Heart and Stroke Foundation • Part of the Registry of the Canadian Stroke Network • Coordinated by staff at the Institute for Clinical and Evaluative Sciences (ICES) • PIs – Patrice Lindsay and Frank Silver

  6. Enables clinicians and administrators to easily access data on stroke care to guide planning, assess performance and promote efficiency. • Web-based tool • First SSPCs joined in fall 2006 • 15 of the 24 SSPCs in Ontario are currently participating

  7. Team Stats • 12 SSPCs reporting data from September 1, 2007 to August 31, 2008 • Initial visits: 5,645 • Event to referral lag time: • mean 11.8 days • median 2.0 days

  8. SSPC’s are not a fountain of youth! Stroke Prevention: Our best defense is a good offense.

  9. Thanks to • Melissa Stamplecoski, Project Manager, Registry of the Canadian Stroke Network, Institute for Clinical Evaluative Sciences • Annette Robertson, Project Manager, Registry of the Canadian Stroke Network, Institute for Clinical Evaluative Sciences • Dr. Frank Silver, Registry of the Canadian Stroke Network, Institute for Clinical Evaluative Sciences • Linda Kelloway, Central South Stroke Education and Research Coordinator, Hamilton Health Sciences

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