Improving stroke care: Quality of care and health education in patients with a stroke or transient ischemic attack

This thesis focuses on the applicability of results of clinical trials of stroke and TIA patients in everyday practice and on measurement of quality of stroke care. A third aim is to further expand an underexposed aspect of stroke care, namely health education in stroke patients. Chapter 2.1 describes which proportion of patients in a stroke population fulfils the enrolment criteria of recently performed randomized controlled trials investigating antiplatelets in stroke patients. Chapter 2.2 focuses on the question whether the combination of low dose aspirin and dipyridamole is more effective than aspirin alone in reducing the risk of recurrent stroke and other major cardiovascular events in patients with a disabling stroke. Chapter 3.1 focuses on the measurement of quality of stroke care by process-of-care indicators. Chapter 4.1 covers the rationale, background and design of the computer-supported individualized health education for TIA and minor stroke patients (COSTA) study. Chapter 4.2 describes the knowledge of stroke and TIA patients about this disease and accessory risk factors and treatment. The main results of the COSTA study are presented in chapter 4.3. Chapter 4.4 provides a review of the literature on health education in stroke and TIA patients. Finally, chapter 5 and 6 provide a general discussion and summary of the results of the studies presented in this thesis.