Pharmaceutical care for patients with ischemic stroke: improving the patients quality of life |
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Authors: | Carina Hohmann Jürgen M Klotz Roland Radziwill Andreas H Jacobs and Thomas Kissel |
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Institution: | (1) Department of Pharmacy and Patient Counselling, Klinikum Fulda gAG, Pacelliallee 4, 36043 Fulda, Germany;(2) Department of Neurology, Klinikum Fulda gAG, Pacelliallee 4, 36043 Fulda, Germany;(3) Department of Pharmaceutical Technology and Biopharmacy, Philipps University of Marburg, Ketzerbach 63, 35037 Marburg, Germany |
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Abstract: | Objectives To improve patients health-related quality of life (HQL) after transient ischemic attack (TIA) or ischemic stroke; to guarantee
an effective secondary prevention; to increase the patient’s satisfaction with recommendations regarding their medication
by pharmacists. Setting Stroke Unit, neurological ward at the Klinikum Fulda, rehabilitation hospitals and community-based pharmacies in the region
of Fulda, Germany. Method Patients with TIA or ischemic stroke were included. The patients were assigned to an intervention group (IG) or a control
group (CG). The individual assignment of patients to IG or CG was based on the type of the local pharmacy to which patients
belong. Community-based pharmacies either delivered standard care (CG) or provided additional intensified pharmaceutical care
(PC; IG). Pharmacies delivering PC belong to a pre-existing “Quality Assurance Working Group” (QAWG). To evaluate the patient’s
HQL, the Short Form-36 (SF-36) was used at study entry in hospital and at 12 months. The secondary prevention was documented
at study entry in hospital and at 12 months. The patients’ satisfaction was measured by a questionnaire at the end of the
study. Main outcome measures Patients’ HQL; secondary prevention; patients’ satisfaction with recommendations of the pharmacists with regards to their
medication. Results Out of 1316 patients screened for participation in this study, 255 were recruited with 90/255 patients assigned to the IG
and 165/255 patients assigned to the CG. During the study, the HQL of the patients in the IG did not change significantly.
A significant decrease in the HQL was observed for the CG in 7/8 subscales and in both summary measures of the SF-36. After
12 months, 85.3% of the patients in the IG and 86.3% of the patients in the CG were treated with antiplatelet drugs or oral
anticoagulants in accordance to treatment guidelines. Patients in the IG were significantly more satisfied with the individualized
recommendations of the pharmacists than patients in the CG. Conclusion 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. |
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Keywords: | Germany Health-related quality of life Patient satisfaction Pharmaceutical Care Seamless Care Secondary prevention Stroke |
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