An audit of the pharmacological management of ischaemic stroke patients in a metropolitan Australian hospital

Abstract

The majority of the cohort was discharged on the appropriate evidence based medications for the management of secondary stroke. Further improvement may be achieved by pharmacist intervening as part of a multidisciplinary team.

Pharmacists as Care Providers for Stroke Patients: A Systematic Review

“…In an another abstract by Hohmann et al, 14 the stroke unit pharmacist identified an average of 1.9 drug therapy problems per patient and resolved over 95% of the problems identified. Khalil et al 15 found that 83% of stroke inpatients who received a medication management review by a pharmacist were on antihypertensive agents, compared to 59% of patients not reviewed by a pharmacist (p = 0.005); 92% were on antithrombotic agents, in contrast to 77% of patients not reviewed by a pharmacist (p = 0.025); while the difference in percentage of patients who were on lipid-lowering agents between the two groups was not significant. Barnett et al 16 found that telephone referral from the hospital to a community pharmacist increased the proportion of patients receiving follow-up within 4 weeks of discharge from 1.5 to 32%.…”

“…Nine studies involved a pharmacist practicing in an inpatient setting. [13][14][15][16][17][18][19][20][21] Hohmann et al 13 demonstrated that a pharmacist completing medication reconciliation and participating in stroke team rounds resulted in identification of drug therapy problems in 68% of the patients, with an average of 1.8 problems per patient. In an another abstract by Hohmann et al, 14 the stroke unit pharmacist identified an average of 1.9 drug therapy problems per patient and resolved over 95% of the problems identified.…”

The Role of Pharmacists in Providing Pharmaceutical Care in Primary and Secondary Prevention of Stroke: A Systematic Review and Meta-Analysis

“…Three studies were of experimental before-and-after design [ 28 , 29 , 30 ], five were cross-sectional [ 31 , 32 , 33 , 34 , 35 ] and fourteen were cohort studies [ 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ]. To capture the breadth of pharmacist interventions, two audit reports [ 50 , 51 ] and five conference abstracts [ 23 , 33 , 40 , 41 , 47 ] were also included for data extraction although quality assessment was not possible using standard tools. Most of the studies assessed were of medium or high quality.…”

“…Individual study characteristics are shown in Table 5 , Table 6 and Table 7 . Seven studies reported pharmacist interventions for primary stroke prevention [ 28 , 29 , 30 , 32 , 33 , 36 , 50 ] and twenty-four focussed on secondary stroke prevention [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 31 , 34 , 35 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 45 , 46 , 47 , 48 , 49 , 51 ].…”

Identifying treatment related problems and associated factors among hospitalized post-stroke patients through medication management review: A multi-center study

“…Such services have been shown to improve patient outcomes for diabetes, hypertension, anticoagulation, and other chronic diseases including stroke (Basheti et al, 2016a, Chiquette et al, 1998, Chisholm-Burns et al, 2010). Significantly more hospitalized stroke patients who received an MMR by a pharmacist were found to be on antihypertensive and antithrombotic agents compared to patients not reviewed previously by the pharmacist (Khalil et al, 2015). A study conducted by McAlister and colleagues has assessed pharmacist-managed drug therapy for dyslipidemia and hypertension in patients with a recent ischemic stroke or tertiary ischemic attacks; within this study, patients in the pharmacist-managed group were more likely to get goal blood pressure and lipid values at six-month interval than patients in the nurse-managed group (McAlister et al, 2014).…”