Medication adherence is a major factor to prevent vascular recurrence after a first ischemic stroke. Nevertheless, it is suboptimal and the implementation of specific interventions are needed to improve it.
A patient - centered and pluriprofessional structured intervention, targeting the medication, introduced at hospital discharge and continued at home (by regular telephone contact) could improve medication adherence one year after stroke.
This intervention would consist of semi structured interviews patient-pharmacist at different times during one year after stroke. The information about the therapeutic management of the patient will be shared between healthcare professionals : general practitioners (GP) and community pharmacists (CP), hospital clinical pharmacist (HCP) and physician (HPhys).
It will allow for decrease of the recurrent stroke and others cardiovascular complications based on a better adherence to preventive medication. Furthermore the decrease of the iatrogenic events and the improvement of the quality of life of patients may be also associated.
- Pharmaceutical care Behavioral
Intervention Desc: Initial interview with pharmacist (at the hospital discharge): Evaluation aimed to identify barriers to adherence to drug treatment followed by an information session on the disease, the benefit of drugs and the importance of diet and lifestyle habits. Pharmacist advices focused on how to take medication and how to manage adverse events will be provided. Telephone interviews with hospital clinical pharmacist - patient (at M3 M6 and M9): The objective is to review with the patient its medication-taking routine and its potential difficulties, to motivate adherence to treatment and lifestyle/dietary rules, to give advices about therapeutics and how to take medication. HCP contacts CP to determine the prescription refill. Final interview with HCP pharmacist (at M12): The objective is to take stock with the patient about its taking drug load. ARM 1: Kind: Experimental Label: Pharmacist Intervention Description: It will be a semi -structured interviews with patient and pharmacist over various time after the stroke (at Month0, M3, M6, M9) combined with patient's therapeutic follow-up from various healthcare professionals.
- Allocation: Non-Randomized
- Masking: Open Label
- Purpose: Supportive Care
- Intervention: Parallel Assignment
|Type||Measure||Time Frame||Safety Issue|
|Primary||Measure of patient's adherence to medication. This adherence measurement is a composite measure||One year after inclusion||No|
|Secondary||Analysis of pharmacy refills||1 year after inclusion||No|
|Secondary||Percentage of patients with drug-related iatrogenic events||1 year after inclusion||No|
|Secondary||Percentage of patients with a new stroke or cardiovascular event||1 year after inclusion||No|
|Secondary||Percentage of patients readmitted in hospitalization||1 year after the inclusion||No|
|Secondary||Realization of a questionnaire (Likert-type scale)||1 year after inclusion||No|
|Secondary||Measure of glycemic and lipid balance.||1 year after inclusion||No|
|Secondary||Realization of a questionnaire scoring (SF-36 scale)||1 year after inclusion||No|
|Secondary||Realization of a questionnaire (Brief IPQR)||1 year after inclusion||No|
|Secondary||Brief IPQR score and medication adherence (Morisky score and pharmacy refills) correlation (composite measure)||1 year after inclusion||No|
|Secondary||Realization of questionnaires (Likert-type scale and SATMED) assessment of satisfaction of patients||1 year after inclusion||No|
|Secondary||Realization of a questionnaire (Likert-type scale) assessment of satisfaction of GP and CP in relation to ADMED-AVC program.||1 year after inclusion||No|