Stroke prevention - Narrowing the evidence-practice gap

Many interventions reduce stroke risk. However, the full benefits of these interventions are not realized at current levels of utilization, as nearly all evidence-based or guideline-endorsed stroke prevention services are und erused. The cause for such underuse is multifactorial and includes factors relating to both patients and providers, as well as to a health care system that has de-emphasized prevention at the expense of acute, technologically based care. Much like the evidence for stroke interventions themselves, th ere is a growing literature to support methods of implementing research evi dence into clinical practice. There is still much to learn, however, about the effectiveness of interventions aimed at achieving changes in stroke pre vention practice or the delivery of stroke prevention care. Nevertheless, t here are many opportunities for providers, managed care organizations, and government to close the evidence-practice gap that exists for stroke preven tion services. These opportunities exist in both the inpatient and outpatie nt setting, and depend on the neurologist taking a leading role in emphasiz ing the critical importance of risk factor identification and modification in all patients at risk for stroke.