OBJECTIVE: To evaluate the adequacy of management of modifiable risk factors (MRF) in a group of ischemic stroke outpatients and the value of pharmacist intervention in a randomized controlled study in a tertiary referral hospital. METHODS: 160 ischemic stroke outpatients from the same catchment area and with the same financial arrangements for healthcare, went through a 6-month equal allocation stratified randomized study. Routine practice was not altered except for a monthly 1-hour pharmacist-intervention education programme. We evaluated the differences in blood pressure (BP), blood glucose and lipid profiles before and after study. The proportion of patients with adequate management of MRF was studied. RESULTS: There were no differences in the demographic characteristics, MRF and medications prescribed throughout the study. Before the study, the proportions of adequate control of BP in the control and intervention groups were 43% vs. 40% (P = 0.64), lipid 27% vs. 13% (P = 0.09) and glucose 36% vs. 21% (P = 0.15) . At the end of the study, the corresponding proportions were for BP 43% vs. 83% (P = 0.00), lipid 27% vs. 40% (P = 0.16) and glucose 46% vs. 35% (P = 0.40). CONCLUSION: Pharmacist intervention was associated with improved BP control but not with the other MRF. Earlier initiation and longer duration of intervention may improve the outcome further, and whether targeting of high-risk subjects may be particularly rewarding is worthy of investigation.
RCT Entities:
OBJECTIVE: To evaluate the adequacy of management of modifiable risk factors (MRF) in a group of ischemic stroke outpatients and the value of pharmacist intervention in a randomized controlled study in a tertiary referral hospital. METHODS: 160 ischemic stroke outpatients from the same catchment area and with the same financial arrangements for healthcare, went through a 6-month equal allocation stratified randomized study. Routine practice was not altered except for a monthly 1-hour pharmacist-intervention education programme. We evaluated the differences in blood pressure (BP), blood glucose and lipid profiles before and after study. The proportion of patients with adequate management of MRF was studied. RESULTS: There were no differences in the demographic characteristics, MRF and medications prescribed throughout the study. Before the study, the proportions of adequate control of BP in the control and intervention groups were 43% vs. 40% (P = 0.64), lipid 27% vs. 13% (P = 0.09) and glucose 36% vs. 21% (P = 0.15) . At the end of the study, the corresponding proportions were for BP 43% vs. 83% (P = 0.00), lipid 27% vs. 40% (P = 0.16) and glucose 46% vs. 35% (P = 0.40). CONCLUSION: Pharmacist intervention was associated with improved BP control but not with the other MRF. Earlier initiation and longer duration of intervention may improve the outcome further, and whether targeting of high-risk subjects may be particularly rewarding is worthy of investigation.
Authors: Barry L Carter; Barcey T Levy; Brian Gryzlak; Elizabeth A Chrischilles; Mark W Vander Weg; Alan J Christensen; Paul A James; Carol A Moss; Christopher P Parker; Tyler Gums; Rachel J Finkelstein; Yinghui Xu; Jeffrey D Dawson; Linnea A Polgreen Journal: Contemp Clin Trials Date: 2015-05-04 Impact factor: 2.226
Authors: Bernadeta Bridgwood; Kate E Lager; Amit K Mistri; Kamlesh Khunti; Andrew D Wilson; Priya Modi Journal: Cochrane Database Syst Rev Date: 2018-05-07
Authors: Anne Forster; Lesley Brown; Jane Smith; Allan House; Peter Knapp; John J Wright; John Young Journal: Cochrane Database Syst Rev Date: 2012-11-14
Authors: Anna De Simoni; Wendy Hardeman; Jonathan Mant; Andrew J Farmer; Ann Louise Kinmonth Journal: J Am Heart Assoc Date: 2013-08-20 Impact factor: 5.501
Authors: Valérie Santschi; Arnaud Chiolero; April L Colosimo; Robert W Platt; Patrick Taffé; Michel Burnier; Bernard Burnand; Gilles Paradis Journal: J Am Heart Assoc Date: 2014-04-10 Impact factor: 5.501