# Using status of secondary prevention medications in post-stroke dysphagia patients: time to raise awareness and develop special formulations

## TL;DR

This study highlights the challenges faced by stroke patients with dysphagia in taking secondary prevention medications and emphasizes the need for specialized formulations.

## Contribution

The study identifies specific medication-related difficulties and preferences among post-stroke dysphagia patients, advocating for tailored pharmaceutical solutions.

## Key findings

- 42.7% of stroke patients experienced dysphagia, leading to higher medication use and gastrointestinal bleeding risks.
- 40.2% of PSD patients had difficulty swallowing pills, and 37.1% crushed solid dosage forms.
- 87.4% of PSD patients expressed a need for specialized formulations with improved swallowability and reduced dosage frequency.

## Abstract

Post-stroke dysphagia (PSD) is an increasingly common complication of stroke. Despite its intuitively unfavorable impact on secondary prevention medication use, limited awareness is available regarding this issue. Herein, a cross-sectional survey was conducted to determine the current use, patient-perceived needs and preferences for secondary prevention medications among PSD patients. To emphasize the unique context related to dysphagia, we recruited Chinese stroke patients with a duration of less than 5 years. These patients were initially categorized into PSD respondents with and without dysphagia. Among the 3490 eligible respondents, 42.7% reported experiencing dysphagia after stroke. Those PSD respondents were more likely to consume multiple medications and suffer from anticoagulants-associated gastrointestinal bleeding as compared to non-PSD ones (p < 0.001). More crucially, 40.2% of them had frequent difficulty in swallowing pills, 37.1% routinely crushed solid oral dosage forms (SODFs), and 23.5% coughed frequently when taking SODFs. In consequence, 87.4% responded a need for PSD-specific formulations where safe swallowing, easy swallowing, and reduced medication frequency were preferred pharmaceutical factors. These findings demonstrate an unsatisfactory situation and definite needs for PSD patients in using secondary prevention medications. Awareness should be increased to develop PSD-specific formulations for safe and effective secondary prevention.