ESOC 2021 | INSPiRE-TMS – an intensive secondary prevention program

Heinrich Audebert, MD, Charité, Center for Stroke Research Berlin, Berlin, Germany, discusses a broad range of secondary prevention programs aimed at reducing the risk of recurrent vascular events, including the open-label, randomized, controlled trial – INSPiRE-TMS (NCT01586702). This intensive program utilized feedback and motivational interviewing strategies with eight out-patient appointments. Findings from over 2000 patients demonstrated improved adherence to secondary prevention targets and improved risk factor control. However, this did not translate to a lower rate of major vascular events such as stroke, acute coronary syndrome and vascular death. Prof. Audebert provides potential explanations for these results including the introduction of bias due to better treatment of patients in the control group compared to the intervention arm. Although there is evidence of a reduction in recurrent stroke events using less intensive strategies, there is a need for replication due to the lack of improvement in risk factor control or adherence to secondary prevention targets in these studies. This interview took place at the European Stroke Organisation Conference (ESOC), 2021.