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Cohort profile: Creation of an E-cohort to Address the Evaluation of Population Secondary Prevention Quality and Outcomes Post-Stroke (ESP-QOPS) in Wales

Daniel King, Libby Ellins Orcid Logo, Hywel Evans Orcid Logo, Nicholas Evans Orcid Logo, Michael Gravenor Orcid Logo, Julian Halcox Orcid Logo, Jonathan Hewitt, Manju Krishnan Orcid Logo, Barry McDonnell, Keeron Stone, Daniel Harris, Ashley Akbari Orcid Logo

International Journal of Population Data Science, Volume: 11, Issue: 1

Swansea University Authors: Daniel King, Libby Ellins Orcid Logo, Hywel Evans Orcid Logo, Michael Gravenor Orcid Logo, Julian Halcox Orcid Logo, Daniel Harris, Ashley Akbari Orcid Logo

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DOI (Published version): 10.23889/ijpds.v11i1.3113

Abstract

Purpose: Secondary prevention of stroke requires effective cardiovascular risk factor (RF) management, including blood pressure control, lipid lowering treatment and antithrombotic therapy to reduce the risk of recurrent stroke. Optimal management of risk factors is challenging in older, frailer peo...

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Published in: International Journal of Population Data Science
ISSN: 2399-4908
Published: Swansea University 2026
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URI: https://cronfa.swan.ac.uk/Record/cronfa71803
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Optimal management of risk factors is challenging in older, frailer people, who also have worse outcomes after a stroke. There is limited evidence evaluating secondary prevention quality and outcomes in frail populations. To understand the trends (and factors associated with inequity) in the provision of RF management we developed the `Evaluation of Population Secondary Prevention Quality and Outcomes Post-Stroke (ESP-QOPS) in Wales' e-cohort. The aims of this project include describing (i) the provision of post-stroke evidence-based risk factor management (ii) trends in frailty and outcomes, and (iii) evaluating the impact of suboptimal risk factor provision on adverse outcomes stratified by frailty status. Participants: We identified 71,696 patients with a first recorded stroke diagnosis in primary or secondary care between 2010-2023 in Wales. Findings to Date: The incidence of stroke gradually increased from 4,968 to 5,391 patients per year between 2010-2023, with 70% of diagnoses made in the secondary care setting. 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spelling 2026-05-13T14:29:14.2342197 v2 71803 2026-04-26 Cohort profile: Creation of an E-cohort to Address the Evaluation of Population Secondary Prevention Quality and Outcomes Post-Stroke (ESP-QOPS) in Wales e23c527859999beb492e07947eb380e5 Daniel King Daniel King true false 553ce2abe05a6396e7dd6eadb6b90a6d 0000-0001-5164-6416 Libby Ellins Libby Ellins true false 73cc98a5b8e4122fdfcee5d88208b0b7 0000-0001-6745-4187 Hywel Evans Hywel Evans true false 70a544476ce62ba78502ce463c2500d6 0000-0003-0710-0947 Michael Gravenor Michael Gravenor true false 3676f695eeda169d0f8c618adf27c04b 0000-0001-6926-2947 Julian Halcox Julian Halcox true false e60c9c73b645f0e8033ae26fa8e634b8 Daniel Harris Daniel Harris true false aa1b025ec0243f708bb5eb0a93d6fb52 0000-0003-0814-0801 Ashley Akbari Ashley Akbari true false 2026-04-26 Purpose: Secondary prevention of stroke requires effective cardiovascular risk factor (RF) management, including blood pressure control, lipid lowering treatment and antithrombotic therapy to reduce the risk of recurrent stroke. Optimal management of risk factors is challenging in older, frailer people, who also have worse outcomes after a stroke. There is limited evidence evaluating secondary prevention quality and outcomes in frail populations. To understand the trends (and factors associated with inequity) in the provision of RF management we developed the `Evaluation of Population Secondary Prevention Quality and Outcomes Post-Stroke (ESP-QOPS) in Wales' e-cohort. The aims of this project include describing (i) the provision of post-stroke evidence-based risk factor management (ii) trends in frailty and outcomes, and (iii) evaluating the impact of suboptimal risk factor provision on adverse outcomes stratified by frailty status. Participants: We identified 71,696 patients with a first recorded stroke diagnosis in primary or secondary care between 2010-2023 in Wales. Findings to Date: The incidence of stroke gradually increased from 4,968 to 5,391 patients per year between 2010-2023, with 70% of diagnoses made in the secondary care setting. Of diagnoses made in primary care, less than 20% were subsequently admitted to secondary care. Journal Article International Journal of Population Data Science 11 1 Swansea University 2399-4908 stroke; cardiovascular disease; secondary prevention; population health 21 4 2026 2026-04-21 10.23889/ijpds.v11i1.3113 COLLEGE NANME COLLEGE CODE Swansea University Other This research was co-funded by Health and Social Care Research Wales alongside a Stroke Association grant [Reference Number: PG2S21\100015]. 2026-05-13T14:29:14.2342197 2026-04-26T17:32:43.6917704 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Daniel King 1 Libby Ellins 0000-0001-5164-6416 2 Hywel Evans 0000-0001-6745-4187 3 Nicholas Evans 0000-0002-7640-4701 4 Michael Gravenor 0000-0003-0710-0947 5 Julian Halcox 0000-0001-6926-2947 6 Jonathan Hewitt 7 Manju Krishnan 0009-0000-8581-5679 8 Barry McDonnell 9 Keeron Stone 10 Daniel Harris 11 Ashley Akbari 0000-0003-0814-0801 12 71803__36718__54ed56067bd74860b1e95031fb7d1738.pdf 71803.VOR.pdf 2026-05-13T14:26:07.4298971 Output 4317791 application/pdf Version of Record true © The Authors. This output is licensed under the Creative Commons Attribution (CC BY) licence. true eng https://creativecommons.org/licenses/by/4.0/deed.en
title Cohort profile: Creation of an E-cohort to Address the Evaluation of Population Secondary Prevention Quality and Outcomes Post-Stroke (ESP-QOPS) in Wales
spellingShingle Cohort profile: Creation of an E-cohort to Address the Evaluation of Population Secondary Prevention Quality and Outcomes Post-Stroke (ESP-QOPS) in Wales
Daniel King
Libby Ellins
Hywel Evans
Michael Gravenor
Julian Halcox
Daniel Harris
Ashley Akbari
title_short Cohort profile: Creation of an E-cohort to Address the Evaluation of Population Secondary Prevention Quality and Outcomes Post-Stroke (ESP-QOPS) in Wales
title_full Cohort profile: Creation of an E-cohort to Address the Evaluation of Population Secondary Prevention Quality and Outcomes Post-Stroke (ESP-QOPS) in Wales
title_fullStr Cohort profile: Creation of an E-cohort to Address the Evaluation of Population Secondary Prevention Quality and Outcomes Post-Stroke (ESP-QOPS) in Wales
title_full_unstemmed Cohort profile: Creation of an E-cohort to Address the Evaluation of Population Secondary Prevention Quality and Outcomes Post-Stroke (ESP-QOPS) in Wales
title_sort Cohort profile: Creation of an E-cohort to Address the Evaluation of Population Secondary Prevention Quality and Outcomes Post-Stroke (ESP-QOPS) in Wales
author_id_str_mv e23c527859999beb492e07947eb380e5
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author_id_fullname_str_mv e23c527859999beb492e07947eb380e5_***_Daniel King
553ce2abe05a6396e7dd6eadb6b90a6d_***_Libby Ellins
73cc98a5b8e4122fdfcee5d88208b0b7_***_Hywel Evans
70a544476ce62ba78502ce463c2500d6_***_Michael Gravenor
3676f695eeda169d0f8c618adf27c04b_***_Julian Halcox
e60c9c73b645f0e8033ae26fa8e634b8_***_Daniel Harris
aa1b025ec0243f708bb5eb0a93d6fb52_***_Ashley Akbari
author Daniel King
Libby Ellins
Hywel Evans
Michael Gravenor
Julian Halcox
Daniel Harris
Ashley Akbari
author2 Daniel King
Libby Ellins
Hywel Evans
Nicholas Evans
Michael Gravenor
Julian Halcox
Jonathan Hewitt
Manju Krishnan
Barry McDonnell
Keeron Stone
Daniel Harris
Ashley Akbari
format Journal article
container_title International Journal of Population Data Science
container_volume 11
container_issue 1
publishDate 2026
institution Swansea University
issn 2399-4908
doi_str_mv 10.23889/ijpds.v11i1.3113
publisher Swansea University
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
document_store_str 1
active_str 0
description Purpose: Secondary prevention of stroke requires effective cardiovascular risk factor (RF) management, including blood pressure control, lipid lowering treatment and antithrombotic therapy to reduce the risk of recurrent stroke. Optimal management of risk factors is challenging in older, frailer people, who also have worse outcomes after a stroke. There is limited evidence evaluating secondary prevention quality and outcomes in frail populations. To understand the trends (and factors associated with inequity) in the provision of RF management we developed the `Evaluation of Population Secondary Prevention Quality and Outcomes Post-Stroke (ESP-QOPS) in Wales' e-cohort. The aims of this project include describing (i) the provision of post-stroke evidence-based risk factor management (ii) trends in frailty and outcomes, and (iii) evaluating the impact of suboptimal risk factor provision on adverse outcomes stratified by frailty status. Participants: We identified 71,696 patients with a first recorded stroke diagnosis in primary or secondary care between 2010-2023 in Wales. Findings to Date: The incidence of stroke gradually increased from 4,968 to 5,391 patients per year between 2010-2023, with 70% of diagnoses made in the secondary care setting. Of diagnoses made in primary care, less than 20% were subsequently admitted to secondary care.
published_date 2026-04-21T06:30:12Z
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