Control of modifiable risk factors in ischemic stroke outpatients by pharmacist intervention: an equal allocation stratified randomized study.
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).


CONCLUSIONS
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.
Department of Pharmacy, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Chun-Chi
CC
Chiu
Shin-Sheng
SS
Wu
Ping-Yi
PY
Lee
Yu-Ching
YC
Huang
Teng-Yeow
TY
Tan
Ku-Chou
KC
Chang
D000368:Aged; D000553:Ambulatory Care / Q000458:organization & administration; D001786:Blood Glucose / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D002545:Brain Ischemia / Q000517:prevention & control*; D002391:Catchment Area, Health; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D010595:Pharmacists; D010607:Pharmacy Service, Hospital / Q000458:organization & administration; D024382:Professional Role; D012307:Risk Factors; D020521:Stroke / Q000517:prevention & control*; D013624:Taiwan
D001786:Blood Glucose; D008055:Lipids