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Title: | Clinical pharmacist implementation of a medication assessment tool for secondary prevention of stroke in older persons |
Authors: | Gauci, Marise Wirth, Francesca Azzopardi, Lilian M. Serracino-Inglott, Anthony |
Keywords: | Medical care -- Research Managed care plans (Medical care) Care of the sick |
Issue Date: | 2018 |
Publisher: | John Wiley & Sons Ltd. |
Citation: | Gauci, M., Wirth, F., Azzopardi, L. M., & Serracino‐Inglott, A. (2018). Clinical pharmacist implementation of a medication assessment tool for secondary prevention of stroke in older persons. Journal of Pharmaceutical Health Services Research, 9(3), 207-214. |
Abstract: | Objectives Ensuring appropriateness of drug therapy is a key component in the care of older persons and may be supported by medication assessment tools (MATs). The aim of this study was to assess whether implementation of a previously developed MAT for the secondary prevention of ischaemic stroke (MAT-CVA) in clinical practice contributes to optimisation of drug therapy and clinical pharmacist intervention documentation. Methods Adherence to the criteria in the developed MAT-CVA was tested by the researcher pre-MAT implementation by application to 150 patients ≥60 years of age, admitted to a rehabilitation hospital with a diagnosis of ischaemic stroke or transient ischaemic attack. Clinical pharmacists in the hospital were subsequently trained on the use of MAT-CVA for the purpose of identification of pharmaceutical care issues and intervention within an interdisciplinary healthcare team. Post-MAT implementation criteria adherence was assessed by the researcher for a further 150 patients with the same inclusion criteria. Key findings MAT-CVA implementation resulted in significant improvement in the prescription of dipyridamole at the recommended dose in combination with aspirin (zscore 2.533, P = 0.011) and of anticoagulation in concurrent atrial fibrillation (z-score 2.468, P = 0.014). Significant improvement was evident in monitoring of liver function following initiation of statin therapy (z-score 4.017, P < 0.001), in monitoring of serum potassium and renal function with angiotensin-converting enzyme inhibitors (z-score 2.632, P = 0.009), and in achievement of blood pressure target (z-score 3.119, P = 0.002) and HbA1c target (z-score 5.278, P < 0.001). Clinical pharmacist intervention documentation improved significantly after implementation of MAT-CVA (z-score 21.661, P < 0.001). Conclusion Implementation of MAT-CVA for use by clinical pharmacists within an interdisciplinary healthcare team significantly contributed to optimisation of drug therapy and pharmacist intervention documentation in older persons admitted to a rehabilitation hospital. |
URI: | https://www.um.edu.mt/library/oar/handle/123456789/48364 |
Appears in Collections: | Scholarly Works - FacM&SPha |
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