Key result
Care in a pharmacist-run stroke prevention clinic significantly reduced the composite endpoint of readmission for stroke/TIA, MI, and new or incidental PAD compared to usual care (P=0.013).
Why the study?
Does a pharmacist-run stroke prevention clinic reduce readmission for cardiovascular events in patients with prior stroke or TIA?
Cohort (n=455)
No
Does a pharmacist-run stroke prevention clinic reduce readmission for cardiovascular events in patients with prior stroke or TIA?
p-value: p=0.013
Pharmacist-led stroke prevention clinics significantly reduce the risk of cardiovascular readmissions and improve risk factor control in patients with prior stroke or TIA.
May support pharmacist-run clinics post-stroke/TIA; hypothesis-generating and requires randomized confirmation.
Background: Patients admitted to our institution with a cerebrovascular accident (stroke) or transient ischemic attack (TIA) are referred to the pharmacist-run stroke prevention clinic (SPC) for medication and risk factor management. Objective: The objective was to determine if patients receiving care from the SPC have better outcomes than patients who received usual care. Methods: This was a retrospective chart review of patients referred to the SPC. At the time of stroke/TIA, before initial visit, and after last SPC visit, risk factor data was collected. Hospital readmissions were reviewed for secondary stroke/TIA, myocardial infarction (MI), and new or incidental peripheral artery disease (PAD). For patients that did not attend SPC visits, data was used as a control. Results: Patients referred to the SPC from October 2012 to December 2014 were reviewed. 455 records were reviewed. The primary composite end point of readmission for stroke/TIA, myocardial infarction, and new or incidental PAD was statistically significantly lower in the SPC group than the control group ( P = .013). All surrogate markers, including blood pressure, Low Density Lipoprotein, Hemoglobin A1c, and smoking status, improved in the SPC group. Conclusion: Pharmacists can play a role in reducing risk factors for secondary stroke/TIA and prevent future hospital admissions.
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Andres et al. (2018) conducted a cohort in Stroke or transient ischemic attack (TIA) (n=455). Pharmacist-run stroke prevention clinic (SPC) vs. Usual care (did not attend SPC visits) was evaluated on Composite of readmission for stroke/TIA, myocardial infarction, and new or incidental PAD (p=0.013). Care in a pharmacist-run stroke prevention clinic significantly reduced the composite endpoint of readmission for stroke/TIA, MI, and new or incidental PAD compared to usual care (P=0.013).
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