Why it matters: Although the 2010 NICE Technology Appraisal recommends dipyridamole for the prevention of further occlusive events in patients who have had a Transient Ischaemic Attack (TIA), 2016 guidance from the Royal College of Physicians states: the Working Party considers that a unified approach to the treatment of TIA and ischaemic stroke is more appropriate. Whilst clopidogrel does not have a licence for use after TIA, the Working Party considers that the benefits of recommending this drug first-line outweigh any disadvantages. For long-term vascular prevention in people with ischaemic stroke or TIA without paroxysmal or permanent atrial fibrillation: - clopidogrel 75mg daily should be the standard antithrombotic treatment; - aspirin 75 mg daily with modified-release dipyridamole 200 mg twice daily should be used for those who are unable to tolerate clopidogrel; - aspirin 75mg daily should be used if both clopidogrel and modified-release dipyridamole are contraindicated or not tolerated; - modified-release dipyridamole 200 mg twice daily should be used if both clopidogrel and aspirin are contraindicated or not tolerated.
Description: Total items for dipyridamole and dipyridamole and aspirin, as a proportion of total items of dipyridamole, dipyridamole & aspirin and clopidogrel (0703021Q0).
CCGs are ordered by mean percentile over the past six months. Each chart shows the results for the individual CCG, plus deciles across all CCGs in the NHS in England.