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Pharmacy World & Science

, Volume 31, Issue 5, pp 550–558 | Cite as

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

  • Carina HohmannEmail author
  • Jürgen M. Klotz
  • Roland Radziwill
  • Andreas H. Jacobs
  • Thomas Kissel
Article

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.

Keywords

Germany Health-related quality of life Patient satisfaction Pharmaceutical Care Seamless Care Secondary prevention Stroke 

Abbreviations

CG

Control group

DGN

German Neurological Society

DRP

Drug-related problems

DSG

German Stroke Society

HQL

Health-related quality of life

IG

Intervention group

MCS

Mental component summary score

MRI

Magnetic resonance imaging

PC

Pharmaceutical care

PCS

Physical component summary score

SF-36

Short Form-36

TIA

Transient ischemic attack

Notes

Acknowledgments

We would like to thank the participating patients, community pharmacists and physicians who supported our study with their commitment.

Funding

The present study was funded by the Förderinitiative Pharmazeutische Betreuung e.V., Berlin and the Dr. August und Dr. Anni Lesmüller Stiftung, Munich, Germany.

Conflict of interests statement

None.

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Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  • Carina Hohmann
    • 1
    • 2
    Email author
  • Jürgen M. Klotz
    • 2
  • Roland Radziwill
    • 1
  • Andreas H. Jacobs
    • 2
  • Thomas Kissel
    • 3
  1. 1.Department of Pharmacy and Patient CounsellingKlinikum Fulda gAGFuldaGermany
  2. 2.Department of NeurologyKlinikum Fulda gAGFuldaGermany
  3. 3.Department of Pharmaceutical Technology and BiopharmacyPhilipps University of MarburgMarburgGermany

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