Pharmacist-Led Transition of Care Protocol in a Primary Stroke Center: A Pilot Intervention Study
2020 ACCP Annual Meeting
Date of original Performance / Presentation
Stroke is the fifth cause of death in the United States and the leading cause of long-term disability. Pharmacist-led transition of care (P-TOC) programs have been shown to reduce morbidity and mortality in chronic conditions, but the effect on secondary stroke prevention is limited.
Research Question or Hypothesis:
Does a P-TOC protocol improve secondary stroke prevention regimen use 30 days post-discharge compared to usual care?
This study was a randomized, open-label, interventional pilot study comparing the P-TOC group versus usual care.
Adult patients admitted with a diagnosis of an ischemic stroke from January to April 2020 were included. Informed consent and baseline data were obtained in the initial encounter. At discharge, patients in the P-TOC group received written education material for anticoagulants, antiplatelets, and high dose statin medications, a medication reconciliation, and a follow-up phone call at 7-14 days post-discharge. All patients were contacted via phone at 30 days post-discharge. The primary endpoint was to evaluate the successful use of the secondary stroke prevention regimen at 30 days post-discharge. A two-sided alpha of 5% was used as the level of significance.
Twenty patients were included in the study, 10 per group. Baseline characteristics were similar across groups. Use of secondary stroke prevention regimen was numerically different but not statistically significant between the P-TOC group and the usual care (antiplatelets: 50% vs. 100%, statins: 100% vs. 90%, anticoagulants: 37.5% vs. 10%, p >0.05). There was no difference in medication adherence, readmission, emergency visits, and mortality.
This P-TOC protocol did not improve the use of indicated medications for secondary stroke prevention compared to the usual care. Secondary stroke prevention medication use in this pilot study was found to be high overall in patients post-stroke. Larger, and long-term prospective studies are needed to evaluate the true effect of the P-TOC protocol in the stroke population.
Medicine and Health Sciences | Pharmacy and Pharmaceutical Sciences
patients, primary stroke center, transition of care protocol, United States
Ramirez, Stephanie Toledo; Silva-Suarez, Georgina; Alvarado, Yarelis; and Perez, Alexandra, "Pharmacist-Led Transition of Care Protocol in a Primary Stroke Center: A Pilot Intervention Study" (2022). Faculty Proceedings, Presentations, Posters, Speeches, Lectures, etc.. 652.