title: Stroke and transient ischemic attack in the long-term care setting: patient characteristics, medication treatment, and length of stay.
abstract: OBJECTIVE
  To examine the percentage of patients treated with antiplatelet or anticoagulant therapy among patients with stroke or transient ischemic attack (TIA) in the long-term care setting.
  
  
  METHODS
  Data were taken from the Minimum Data Set. Information regarding medications was derived from a linked pharmacy-claims database.
  
  
  METHODS
  Long-term care facilities.
  
  
  METHODS
  Residents of long-term care facilities with stroke or TIA as indicated in the database between January 1, 2007, and December 31, 2008, were selected; 14,469 patients with stroke and 833 patients with TIA were identified.
  
  
  METHODS
  None. MAIN STUDY VARIABLES: Demographics, admission and payer source, residential history, quality measures, comorbidities, and antiplatelet and anticoagulant therapies received.
  
  
  RESULTS
  Approximately 48% of stroke patients and 53% of TIA patients received any antiplatelet or anticoagulant medication. Stroke patients had a mean (standard deviation [SD]) of 19.5 (73.2) days from their first assessment to their first medication, and they received therapy for a mean (SD) of 112.3 (258.3) days. TIA patients had a mean (SD) of 13.7 (54.9) days from their first assessment to their first medication, and they received therapy for a mean (SD) of 67.0 (165.7) days. In both cohorts, clopidogrel was the most common therapy received (22.5% of stroke patients and 24.6% of TIA patients).
  
  
  CONCLUSIONS
  Health care providers treating patients in the long-term care setting should be aware of the population characteristics and high rate of undertreatment observed in this analysis. This study may help inform optimal decision-making by physicians and other health care practitioners.
authors.affiliation: RTI Health Solutions, Research Triangle Park, North Carolina 27709, USA. jmeyers@rti.org
authors.forename: Juliana L
authors.initials: JL
authors.lastname: Meyers
authors.forename: Keith L
authors.initials: KL
authors.lastname: Davis
authors.forename: Yanni F
authors.initials: YF
authors.lastname: Yu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D000077144:Clopidogrel; D016208:Databases, Factual; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000188:drug therapy*; D007902:Length of Stay; D008134:Long-Term Care / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D020521:Stroke / Q000188:drug therapy*; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D013997:Time Factors
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine