Pharmaceutical care for patients with ischemic stroke: improving the patients quality of life

Abstract

Our findings indicate that an intensified PC of patients after ischemic stroke by dedicated pharmacists may have a positive impact on HQL and patients' satisfaction. PC in this study had no impact on adherence to secondary prevention medication.

Health system barriers and facilitators to medication adherence for the secondary prevention of cardiovascular disease: A systematic review

“…18 Of the 25 included studies, 11 were randomised controlled trials (RCTs); 17 19-28 1 was a nonrandomised trial, 29 11 were cohort studies, 18 30-39 1 was cross-sectional 25 and 1 was case-control. 40 Other than 3 studies including upper middle-income countries 24 25 and one including a low middle-income country, 20 21 of the 25 studies (84%) were conducted in countries classified as high-income countries, 9 of which were in the USA.…”

“…17 19 24 33 35 37 40 One study focused on antiplatelet drugs including aspirin. 29 One study investigated β blockers, statins and ACEI/ARB 34 and one considered aspirin, ACEI and statin 25 (see online supplementary appendix table 2c).…”

“…29 The US trial included 30 patients following CABG, randomised to weekly pharmacist telephone calls for 3 months or usual care. Adherence to statins was higher in the intervention group versus the control group at 1 year (71% vs 47%; p<0.05) and at 2 years (63% vs 39%) as measured by prescription refill, using the χ 2 test.…”

“…20 25 26 28 Copayments, insurance and prescription coverage were all associated with increased adherence from 120 days to 1 year. 27 34 35 Two RCTs 23 24 and one non-randomised trial 29 had persistence outcomes, and only one RCT showed a positive impact of counselling on statin persistence at 15 months median follow-up 24 (see online supplementary table 1b). The only trial considering persistence and adherence did not show effect on these outcomes.…”

Contemporary Management of Transient Ischemic Attack: Role of the Pharmacist

“…17 Pharmacist-led interventions, such as drug therapy review, counseling on the mechanisms of action of drugs, adverse effects, and drug interactions, as well as risk factor modification, in the year after an ischemic stroke may help maintain patients' health-related quality of life and improve their satisfaction with care. 18 Pharmacists can also provide patient counseling on nonpharmacologic and pharmacologic approaches to risk factor modification; the efficacy and safety of therapeutic interventions; the importance of drug adherence; and the risk of potential diet, herbal, and drug interactions with agents commonly used in prevention regimens, which may interfere with achievement of optimal therapeutic goals. Potential drug-drug interactions to be aware of in patients treated with antiplatelet therapy for primary or secondary stroke prevention are listed in Table 1.…”