To evaluate the effects of the 1-year pharmaceutical care program offered by the clinical pharmacist to the patients admitted to the neurology service with the diagnosis of stroke, on medication adherence, quality of life, and clinical outcomes of the patients.
The study was conducted as a parallel randomized controlled study in the Neurology Clinic of a University Hospital in Turkey. Patients were randomly assigned to intervention and usual care groups. While the patients in the usual care group are given routine health services by the neurologist during their hospitalization and for 1 year after discharge; In addition to these routine services, the intervention group was provided with pharmaceutical care by a clinical pharmacist during the same period. The study was always conducted by the same neurologist and clinical pharmacist. Patient medication adherence, quality of life, and clinical parameters were evaluated at the beginning of the study and at the 12th month.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
260
Within the scope of pharmaceutical care, medication review services for past and current medication use were provided by the clinical pharmacist. The patients in the intervention group were given verbal information about the definition of stroke, symptoms, how to manage risk factors, and their medications by the clinical pharmacist on the day of discharge, in addition to the neurologist. Each patient in the intervention group had a scheduled meeting with the clinical pharmacist. During the 1-year follow-up the patient education given by the clinical pharmacist was repeated every 3 months.
Marmara University Pendik Research and Training Hospital
Istanbul, Turkey (Türkiye)
Blood pressure
Blood pressure was checked and recorded by a qualified nurse during the hospital stay and at control visits. Measurements were recorded as mmHg.
Time frame: 1, 3, 6, 9 and 12 months
Medication Adherence
Adherence to Stroke Prevention Medications (Anti platelets, Anticoagulants, Statins, antihypertensives, antidiabetics) measured by Morisky-Green-Levine Adherence Scale (1-4) where higher scores indicate higher levels of reported adherence.
Time frame: 3, 6, 9 and 12 months
HbA1c
HbA1c (glycated hemoglobin) value was collected from medical records and recorded as a percentage.
Time frame: 1, 3, 6, 9 and 12 months
LDL cholesterol
Low density lipoprotein-cholesterol level was collected from medical records and recorded as mg/dL
Time frame: 1, 3, 6, 9 and 12 months
Triglyceride
Triglyceride level was collected from medical records and recorded as mg/dL.
Time frame: 1, 3, 6, 9 and 12 months
Body mass index
Body mass index (BMI) was collected from medical records and recorded as kg/m2
Time frame: 1, 3, 6, 9 and 12 months
Measuring Quality of Life
The patients' quality of life was evaluated using the Stroke-Specific Quality of Life Scale (SSQOL), and the total quality of life score was calculated, a higher score indicates that the patient has a better quality of life.
Time frame: 3, 6 and 12 months
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The National Institutes of Health Stroke Scale
The National Institutes of Health Stroke Scale, or NIH Stroke Scale (NIHSS), is a tool used by healthcare providers to objectively quantify the impairment caused by a stroke and aid in planning post-acute care disposition.
Time frame: 24 hours before discharge, 3, 6, 9 and 12 months
Stroke Recurrence
Stroke recurrence (radiologically and clinically confirmed) within 1 year
Time frame: 1 year
Drug Related Problem
Determination of drug-related problems (DRP) using Pharmaceutical Care Network Europe (PCNE) Version 9.1. The basic classification has 3 primary domains for problems, 9 primary domains for causes and 5 primary domains for Planned Interventions, 3 primary domains for level of acceptance (of interventions) and 4 primary domains for the Status of the problem.
Time frame: 1 year