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Master Thesis

Activité d'éducation ciblée : évaluation du programme mis en place dans le service de Neurologie du Centre Hospitalier de la Côte Basque après un AVC ischémique d'origine cardioembolique traité par anticoagulant

Abstract : Introduction: one-fifth of ischemic strokes are caused by a cardioembolic pathology : atrial fibrillation (AF). Anticoagulant treatments reduce the risk of recurrent stroke by 60% but they are also the leading cause of severe iatrogenic effects in France. In more than 2 out of 5 cases, iatrogenic risks can be prevented since they come from non-compliant uses. The inclusion of therapeutic patient education in the prevention strategy could help to improve the efficacy and safety of drug use. The aim of the present study was to assess the effectiveness of targeted education workshops set up in the Unit of Intensive Neuro-Vascular Care (USINV) of the Basque Coast Hospital Center. Methods: through a descriptive prospective observational and descriptive study, we compared two groups, the first group received the usual care, hereby called "simple oral information" (IOS), and the second group participated to a targeted education workshop (AEC). We included in the study patients hospitalized between the months of May and November 2015 in the USINV for an ischemic stroke caused by non-valvular AF and treated with anticoagulant. The primary endpoint was a composite criterion of ischemic stroke recurrence and hemorrhagic complication rate after 6 months. Results: 33 patients have been followed, including 5 who participated to AEC. After 6 months, no complication was observed in the AEC group while we noted the occurrence of 5 events (17.85%) in the IOS group: 1 ischemic recurrence, 1 major hemorrhagic complication and 3 minor hemorrhagic complications. Conclusion: it appears that participation in AEC induces a reduction in ischemic and haemorrhagic complications. However, in the absence of randomization and because of a too small sample, it is not possible to draw conclusions, these results must be confirmed by a larger-scale study.
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https://dumas.ccsd.cnrs.fr/dumas-02498260
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Matthieu Delage. Activité d'éducation ciblée : évaluation du programme mis en place dans le service de Neurologie du Centre Hospitalier de la Côte Basque après un AVC ischémique d'origine cardioembolique traité par anticoagulant. Médecine humaine et pathologie. 2019. ⟨dumas-02498260⟩

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