Department of Pharmacy, The First Hospital of Hebei Medical University, Shijiazhuang, 050031, Hebei, China.
School of Pharmacy, Hebei Medical University, Hebei, Shijiazhuang, 050011, Hebei, China.
Int J Clin Pharm. 2021 Oct;43(5):1412-1419. doi: 10.1007/s11096-021-01272-9. Epub 2021 Apr 28.
Background Effective secondary prevention is essential for reducing stroke recurrence. Objective This parallel randomized-controlled study aimed to evaluate the impact of a pharmaceutical care program on risk factor control (blood pressure, blood glucose, lipid profile, and medication adherence) and hospital readmissions in post-stroke care. Setting The First Hospital of Hebei Medical University, China. Method Ischemic stroke patients were enrolled in the study. Upon hospital discharge, patients were randomly allocated either to a control group (CG, no pharmaceutical care) or to an intervention group (IG, monthly pharmaceutical care follow-up for 6 months). The interventions aimed to increase medication adherence and improve risk factor control through education and counseling. Medication adherence and surrogate laboratory markers of risk factors were assessed and compared between the two groups. Main outcome measures Blood pressure, blood glucose, lipid profile, and medication adherence. Results A total of 184 patients with ischemic strokes were randomly assigned, and 84 patients in IG and 82 in CG were analyzed. There were no significant differences (P > 0.05) in both groups concerning demographic and clinical characteristics. Compared to CG, at the 6-month follow-up, medication adherence rates significantly increased regarding antihypertensive drugs (92.86% versus 78.57%, P = 0.031), anti-diabetic drugs (91.67% versus 69.7%, P = 0.02), and lipid-lowering drugs (77.38% versus 60.98%, P = 0.022) in IG. Compared to CG, more patients in IG attained the goal surrogate risk factor control markers of hemoglobin A1c (87.88% vs. 52.78%, P = 0.038) and low-density lipoprotein-C (66.67% vs. 48.78%, P = 0.02). Significantly fewer patients were re-admitted to the hospital in IG than CG (7.14% vs. 18.3%, P = 0.03). Conclusion Pharmaceutical care programs can improve risk factor control for the secondary prevention of stroke recurrence in ischemic stroke patients.
背景
有效的二级预防对于降低卒中复发至关重要。
目的
本平行随机对照研究旨在评估药学保健方案对卒中后患者的危险因素控制（血压、血糖、血脂和药物依从性）和再住院的影响。
设置
河北医科大学第一医院，中国。
方法
纳入缺血性卒中患者。患者出院时，随机分配至对照组（CG，无药学保健）或干预组（IG，每月进行 6 个月的药学保健随访）。干预措施旨在通过教育和咨询提高药物依从性并改善危险因素控制。评估并比较两组之间的药物依从性和危险因素替代实验室标志物。
主要结局指标
血压、血糖、血脂和药物依从性。
结果
共纳入 184 例缺血性卒中患者，其中 84 例分配至 IG，82 例分配至 CG。两组在人口统计学和临床特征方面无显著差异（P>0.05）。与 CG 相比，IG 在 6 个月随访时降压药物（92.86%比 78.57%，P=0.031）、降糖药物（91.67%比 69.7%，P=0.02）和降脂药物（77.38%比 60.98%，P=0.022）的药物依从率显著增加。与 CG 相比，IG 更多患者达到糖化血红蛋白（87.88%比 52.78%，P=0.038）和低密度脂蛋白-C（66.67%比 48.78%，P=0.02）的目标替代危险因素控制标志物。IG 再住院患者明显少于 CG（7.14%比 18.3%，P=0.03）。
结论
药学保健方案可改善缺血性卒中患者卒中复发二级预防的危险因素控制。
