Evaluation of Clinical Pharmacist-led Chronic Disease Management in 184 Patients with Ischemic Stroke / 中国药房

ABSTRACT

OBJECTIVE： To evaluate the effects of clinical pharmacist-led ischemic stroke management， and to provide reference for chronic disease management. METHODS： Totally 184 patients with ischemic stroke who were hospitalized in neurology department of the First Hospital of Hebei Medical University from May to August 2018 were included prospectively， and then divided into control group （92 cases） and intervention group （92 cases） by random number method. Control group did not receive clinical pharmacist intervention. In the intervention group， clinical pharmacists were the leader in the pharmaceutical care during the hospitalization， the medication education at discharge， and pharmacy follow-up after discharge. The rate of medication compliance （antiplatelet drugs， antihypertensive drugs， hypoglycemic drugs and lipid-lowering drugs） and the rate of secondary prevention and control indicators of ischemic stroke， such as blood pressure， blood glucose [glycated hemoglobin （HbA1c）] and blood lipid [low-density lipoprotein cholesterol （LDL-C）] were investigated between 2 groups at 6 months after discharge. The incidence of adverse drug reaction and the rate of rehospitalization were compared between 2 groups at 6 months after discharge. RESULTS： The number of patients in the intervention group and the control group was 84 and 82， respectively. At 6 months after discharge， the compliance rate of antiplatelet drugs in the intervention group was 96.43％， which was higher than 95.13％ of control group， but the difference was not statistically significant. The good compliance rates of antihypertensive drugs， hypoglycemic drugs and lipid-lowering drugs in the intervention group were 92.86％， 91.67％ and 77.38％， which were higher than 78.57％， 69.70％ and 60.98％ of control group， with statistical significance （P＜0.05）. The qualified rate of index of blood pressure was 89.29％ in intervention group， which was higher than 76.79％ of control group， but the difference was not statistically significant. The qualified rates of HbA1c and LDL-C in the intervention group were 80.56％ and 66.67％， which were higher than 57.58％ and 48.785 of control group， with statistical significance （P＜0.05）. The incidence of total adverse drug reactions in the intervention group was 15.48％， which was lower than 20.73％ of control group， but the difference was not statistically significant. The total rehospitalization rate in the intervention group was 7.14％， which was lower than 17.86％ of control group， the difference was statistically significant （P＜0.05）. CONCLUSIONS： The management of ischemic stroke patients with clinical pharmacists as the leading factor can improve the patient’s medication compliance， improve the qualified rate of secondary prevention and control indicators of ischemic stroke， and reduce the rate of rehospitalization.