Tailored Intervention to Improve Patient Adherence to Secondary Stroke Prevention Medication

Completed

Phase N/A Results N/A

Trial Description

Patient suffering a Transient Ischemic Attack (TIA) or stroke are subsequently at high risk of a new stroke, however, poor adherence to secondary prevention medications occurs frequently within this patient group. The purpose of this study is to evaluate whether a complex tailored pharmacist intervention will lead to increased adherence to secondary stroke prevention medications and less new stroke events when compared to a usual care group. Interventions focus on motivational interviewing, medication review and telephone follow up.

Conditions

Interventions

  • Usual care Other
    ARM 1: Kind: Experimental
    Label: Complex tailored intervention
    Description: The intervention consists of 3 elements: Medication review with recommendations focused on antithrombotics and adherence to guidelines and patient´s adherence to medications. Discharge consultation with an pharmacist using motivational interviewing techniques. Follow-up telephone calls one week, two months and six months after discharge.
    ARM 2: Kind: Experimental
    Label: Usual care
    Description: Usual care
  • Complex tailored intervention Behavioral
    ARM 1: Kind: Experimental
    Label: Complex tailored intervention
    Description: The intervention consists of 3 elements: Medication review with recommendations focused on antithrombotics and adherence to guidelines and patient´s adherence to medications. Discharge consultation with an pharmacist using motivational interviewing techniques. Follow-up telephone calls one week, two months and six months after discharge.

Trial Design

  • Allocation: Randomized
  • Masking: Single Blind (Outcomes Assessor)
  • Purpose: Prevention
  • Endpoint: Efficacy Study
  • Intervention: Parallel Assignment

Outcomes

Type Measure Time Frame Safety Issue
Primary Medication adherence to antiplatelets, anticoagulants and lipid-lowering therapies One year from inclusion No
Secondary Medication adherence to antihypertensive therapies One year from inclusion No
Secondary Stroke leading to hospital admission One year from inclusion No
Primary Medication Adherence to antiplatelets, anticoagulants and statins measured by proportion of days covered (PDC). One year from inclusion No
Primary For antiplatelets, anticoagulants and statins: Percent of patients that are at least 80% adherent (PDC>0.8) 1 year from inclusion No
Secondary Medication Adherence to antihypertensives measured by proportion of days covered (PDC) One year from inclusion No
Secondary Percent of patients that are at least 80% adherent (PDC>0.8) to antihypertensives One year from inclusion No
Secondary Non-persistence with thromboprophylactic agents ( antiplatelets, anticoagulants, statins and antihypertensives) measured by percent of patients that are not supplied with medication for more than 3 continuous months One year from inclusion No
Secondary Accept rate for thromboprophylactic agents measured by percent of patients starting treatment within 0-90 days after discharge. 3 months from discharge No
Secondary Number of patients with a new stroke event leading to hospital admission One year from inclusion No
Secondary Composite endpoint: stroke, myocardial infarction or cardiovascular death One year from inclusion No

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