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International Journal of Clinical Pharmacy

, Volume 39, Issue 5, pp 1008–1012 | Cite as

Design and application of a medication assessment tool for secondary prevention of stroke

  • Marise GauciEmail author
  • Francesca Wirth
  • Liberato Camilleri
  • Lilian M. Azzopardi
  • Anthony Serracino-Inglott
Short Research Report

Abstract

Background Optimisation of drug therapy is essential in the care of older persons and may be facilitated by application of medication assessment tools (MATs). Objective To design, psychometrically evaluate and apply an innovative MAT for secondary prevention of ischaemic stroke with particular relevance to older persons. Method Review criteria were selected from clinical practice guidelines and MAT-CVA was developed, validated and tested for reliability and feasibility. MAT-CVA was applied to 150 patients with a diagnosis of ischaemic stroke or transient ischaemic attack admitted to a rehabilitation hospital. Results MAT-CVA consists of 17 criteria sectioned into antithrombotic, lipid lowering, antihypertensive and glycaemic therapy. Content validity was demonstrated for all criteria. Reliability was confirmed with kappa values of 0.80 for both inter- and intraobserver agreements. Mean application time for the two observers was 5.55 and 6.56 min. Adherence to applicable criteria was 55% and justified non-adherence was 22.3%. Non-adherence was predominantly evident for prescription of anticoagulation in concurrent atrial fibrillation (36.4%), thiazide diuretics ± angiotensin converting enzyme inhibitors for hypertension (26.8%) and dipyridamole at the recommended dose (24.0%). Conclusion Application of MAT-CVA indicated good overall adherence and identified gaps in clinical performance which may be targeted to enhance drug therapy optimisation.

Keywords

Elderly Ischaemic stroke Medication assessment tool Quality of care 

Notes

Acknowledgements

The authors would like to thank the consultant geriatricians, consultant neurologists and clinical pharmacists who participated in the validity, reliability and feasibility testing.

Funding

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Conflicts of interest

The authors declare that they have no conflict of interest to disclose.

Supplementary material

11096_2017_515_MOESM1_ESM.pdf (16 kb)
Supplementary material 1 (PDF 15 kb)

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of Pharmacy, Faculty of Medicine and SurgeryUniversity of MaltaMsidaMalta
  2. 2.Department of PharmacyRehabilitation Hospital Karin GrechPietaMalta
  3. 3.Department of Statistics and Operations Research, Faculty of ScienceUniversity of MaltaMsidaMalta

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