Pharmacists’ Impact on Secondary Stroke Prevention

Abstract

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.