Case management for blood pressure and lipid level control after minor stroke: PREVENTION randomized controlled trial

McAlister, Finlay A.; Majumdar, Sumit R.; Padwal, Raj; Fradette, Miriam; Thompson, Ann; Buck, Brian; Dean, Naeem; Bakal, Jeffrey A.; Tsuyuki, Ross T.; Grover, Steven A.; Shuaib, Ashfaq

doi:10.1503/cmaj.140053

Cited by 72 publications

(87 citation statements)

References 33 publications

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“…11 Initially medical colleagues raised concerns about pharmacists taking on prescribing responsibilities due to pharmacists' limited diagnostic skills however these issues appear to have resolved over time and many PIPs are now integrated into the multidisciplinary team. 12 While most published literature on pharmacist prescribing describes primary care management of chronic conditions such as hypertension and secondary prevention in stroke, 13,14 there is potential to impact patient care and safety in hospital settings.…”

Section: Introductionmentioning

confidence: 99%

What supports hospital pharmacist prescribing in Scotland? – A mixed methods, exploratory sequential study

Fisher

Kinnear

Reid

et al. 2018

Research in Social and Administrative Pharmacy

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Section: Introductionmentioning

confidence: 99%

What supports hospital pharmacist prescribing in Scotland? – A mixed methods, exploratory sequential study

Fisher

Kinnear

Reid

et al. 2018

Research in Social and Administrative Pharmacy

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“…Seven studies showed benefit in clinical patient outcomes. These studies found improved risk factor control in patients with prior stroke, 25 reduced systolic blood pressure 26,31 and low-density lipoprotein cholesterol, 27 improved glycemic control in patients with poorly controlled type 2 diabetes 22 and improved quality of life in patients with uncontrolled type 2 diabetes in a cost-effective manner. 32 Better chronic disease management as well as significant symptomatic improvement was reported by 81% of patients when pharmacists prescribed CLInICAL RevIeW medications for minor ailments (i.e., ambulatory conditions) in Saskatchewan.…”

Section: Resultsmentioning

confidence: 99%

“…Quantitative articles used surveys (8 studies), 2,14-20 experiments (3 studies), [21][22][23] randomized controlled trials (5 studies) [24][25][26][27][28] and others (4 studies). [29][30][31][32] Qualitative studies explored perceptions of pharmacists 33 or pharmacy students 34 (2 studies), stakeholders (3 studies), [35][36][37] media (1 study) 38 and different factors influencing the practice change (5 studies).…”

Section: Resultsmentioning

confidence: 99%

“…18,[22][23][24][25][26][27][28][29][30][31][32]48 Among 12 quantitative studies, 5 were randomized controlled trials. [24][25][26][27][28] Perception or insight about pharmacist prescribing was evident in 10 studies (Table 2). Researchers used different perspectives, such as the general public, students, government agencies, physicians and pharmacists themselves, to understand the insight.…”

Section: Resultsmentioning

confidence: 99%

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A scoping review of research on the prescribing practice of Canadian pharmacists

Faruquee

Guirguis

2015

Can Pharm J

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Background: Pharmacists in Canada have been prescribing since 2007. This review aims to explore the volume, array and nature of research activity on Canadian pharmacist prescribing and to identify gaps in the existing literature. Methods: We conducted a scoping review to examine the literature on prescribing by pharmacists in Canada according to methodological trends, research areas and key findings. We searched for peer-reviewed research articles and abstracts in the Ovid MEDLINE, Ovid EMBASE and International Pharmaceutical Abstracts databases without any date limitations. A standardized form was used to extract information. Results: We identified 156 articles; of these, 26 articles and 12 abstracts met inclusion criteria. One-half of the research studies (20) used quantitative methods, including surveys, trials and experimental designs; 11 studies used qualitative methods and 7 used other methods. Research on pharmacist prescribing demonstrated an improvement in patient outcomes (13 studies), varied stakeholder perceptions (10 studies) and factors that influence this practice change (11 studies). Pharmacist prescribing was adopted when pharmacists practised patient-centred care. Stakeholders held contrasting perceptions of pharmacist prescribing. Discussion: Canadian research has demonstrated the benefit of pharmacist prescribing on patient outcomes, which is not present in the international literature. Future research may consider a meta-analysis addressing the impact on patient health. Gaps in research include comparisons between provinces, effects on physicians’ services, overall patient safety and access to health care systems and economic implications for society. Conclusion: A growing body of research on pharmacist prescribing has captured the early impact of prescribing on patient outcomes, perceptions of practice and practice change. Opportunities exist for pan-Canadian research that examines the system impact.

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“…2014; McAlister et al. 2014). A recent study comparing usual outpatient care with an organized post‐stroke program in patients with minor stroke and TIA showed that about 25% of patients who initially agreed to participate did not attend the scheduled outpatient follow‐up appointments (Leistner et al.…”

Section: Discussionmentioning

confidence: 99%

The stroke east Saxony pilot project for organized post‐stroke care: a case–control study

et al. 2016

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BackgroundLow adherence to secondary prevention guidelines in stroke survivors may increase the risk for recurrent stroke and adversely impact quality of life. We aimed to determine the feasibility of a self‐developed standardized post‐stroke pathway and its impact on secondary stroke prevention and long‐term outcome in patients with acute stroke.MethodsConsecutive patients with acute stroke were prospectively included in a standardized post‐stroke pathway accomplished through a single certified CM (case manager), which comprised educational discussions and quarterly checkups for vascular risk factors and adherence to antithrombotic/anticoagulant medication in addition to usual care. At 12 months, we compared achieved target goals for secondary prevention, functional outcome, stroke recurrence, and vascular death with age‐ and gender‐matched controls that received only usual care after stroke.ResultsWe included 45 cases and 45 controls. The following target goals were more frequently achieved in CM‐patients than in controls: blood pressure (100% vs. 46.2%, P < 0.001), cholesterol (100% vs. 74.4%, P < 0.001), and body mass index (67.4% vs. 46.2%, P = 0.052). The CM‐intervention emerged as an independent predictor of favorable functional outcome (mRS ≤ 2) at 12 months after adjusting for stroke severity and systemic thrombolysis (OR: 4.27; 95%CI:1.2–15.21; P = 0.025). Quality of life was rated significantly higher in CM‐patients than in controls (P = 0.049). As opposed to controls, none of the cases experienced a recurrent stroke (0% vs. 13.3%; P = 0.026) or suffered from vascular death (0% vs. 6.7%; P = 0.242).ConclusionsOur pilot data suggest that organized post‐stroke care enhances achievement of secondary prevention goals. Its possible effect on stroke recurrence, long‐term disability, and quality of life is currently investigated in a prospective cohort study.

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Case management for blood pressure and lipid level control after minor stroke: PREVENTION randomized controlled trial

Cited by 72 publications

References 33 publications

What supports hospital pharmacist prescribing in Scotland? – A mixed methods, exploratory sequential study

What supports hospital pharmacist prescribing in Scotland? – A mixed methods, exploratory sequential study

A scoping review of research on the prescribing practice of Canadian pharmacists

The stroke east Saxony pilot project for organized post‐stroke care: a case–control study

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