Impact of a Pluriprofessional Intervention to Improve Medication Adherence (Secondary Preventive Medication) in Patients After Ischemic Stroke (ADMED-AVC)

Civil Hospices of Lyon

Status: Unknown

Conditions: Ischemic Stroke

Treatments: Behavioral: Pharmaceutical care

Study type: Interventional

Funder types: Other

Identifiers

NCT02611440

2014.859

Details and patient eligibility

About

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.

Enrollment: 182 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Aged ≥ 18 years
• Patient with ischemic stroke hospitalized in physical medicine and rehabilitation unit or neurovascular unit
• Return at home at the hospital discharge
• Medication including an antiplatelet drug or an oral anticoagulant with at least an antihypertensive drug and/or a lipid lowering agent (statin)
• Patient without either cognitive disorders or major psychiatric disorders
• Patient with a sufficient autonomy for the management of medication at home (score of Barthel > 30)

Exclusion criteria

• Patient ≤ 18 years
• Patient with important cognitive or psychiatric disorders
• Management of patient medication exclusively by the helper
• No usual pharmacy (or more than 2 usual pharmacies)
• Patient directed to an institution at the end of the hospitalization

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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182 participants in 2 patient groups

Pharmacist Intervention

Experimental group

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.

Treatment:

Behavioral: Pharmaceutical care

Control

No Intervention group

Description:

No pharmacist intervention planned.