Background and Purpose -The Stroke PROTECT (Preventing Recurrence Of Thromb oembolic Events through Coordinated Treatment) program systematically implements , at the time of acute transient ischemic attack (TIA) or ischemic stroke admiss ion, 8 medication/behavioral secondary prevention measures known to improve outc ome in patients with cerebrovascular disease. The objective of this study was to determine if the high utilization rates previously demonstrated at hospital dis charge were maintained at 90 days after discharge. Methods -Data were prospect ively collected on consecutively encountered ischemic stroke and TIA patients ad mitted to a university hospital stroke service beginning September 1, 2002. PROT ECT interventions were initiated before hospital discharge in all PROTECT-targ et (underlying stroke mechanism large vessel atherosclerosis or small vessel dis ease) and PROTECT-ACS (At-risk for Coronary Sequelae) patients. Adherence to program goals was assessed 3 months after discharge. Results -During the peri od from September 2002 to August 2003, 144 individuals met criteria for PROTECT intervention. Of the 130 patients (90% ) with available day 90 follow-up data , mean age was 72 (range, 37 to 95), and 63% were male. Adherence rates in pat ients without specific contraindications were 100% for antithrombotics, 99% for statins, 92% for angiotensin-converting enzyme inhibitors/angiotensin re ceptor blockers, and 80% for thiazides. Awareness of the importance of calling 911 in response to stroke was 87% . Adherence to diet and exercise guidelines were 78% and 70% , respectively. Of the 24 smokers, tobacco cessation was mai ntained in 20 (83% ). Conclusions -High rates of adherence to PROTECT therapi es were maintained at 90 days after hospital discharge. Background and Purpose-The Stroke PROTECT (Preventing Recurrence Of Thromboembolic Events through Coordinated Treatment) systematically implements, at the time of acute transient ischemic attack (TIA) or ischemic stroke exposure, 8-medication / behavioral secondary prevention measures known to improve outc ome in patients with cerebrovascular disease. The objective of this study was to determine if the high utilization rates were previously demonstrated at hospital dis charge were maintained at 90 days after discharge. Methods-DATA were prospected ively collected on consecutively encountered ischemic stroke and TIA patients ad mitted to a university hospital stroke service beginning September 1, 2002. PROT ECT interventions were initiated before hospital discharge in all PROTECT-targ et (underlying stroke mechanism large vessel atherosclerosis or small vessel dis ease) and PROTECT-ACS (At-risk for Coronary Sequelae) patients. Adherence to program goals was assessed 3 months after discharge-Results of the peri od from September 2002 to August 2003, 144 met criteria for PROTECT intervention. Of the 130 patients (90%) with available day 90 follow-up data, mean age was 72 (range, 37 to 95 ), and 63% were male. Adherence rates in pat ients without specific contraindications were 100% for antithrombotics, 99% for statins, 92% for angiotensin-converting enzyme inhibitors / angiotensin re ceptor blockers, and 80% for thiazides. Awareness of the importance of calling 911 in response to stroke was 87%. Adherence to diet and exercise guidelines were 78% and 70% respectively. Of the 24 smokers, tobacco cessation was mai ntained in 20 (83%). Conclusions -High rates of adherence to PROTECT therapi es were maintained at 90 days after hospital discharge.