Impact of a Pluriprofessional Intervention to Improve Medication Adherence (Secondary Preventive Medication) in Patients After Ischemic Stroke (ADMED-AVC)
试验速览
- 阶段
- 不适用
- 入组人数
- 182
- 试验地点
- 12
- 主要终点
- Measure of patient's adherence to medication. This adherence measurement is a composite measure
研究概览
简要总结
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.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •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)
排除标准
- •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
结局指标
主要结局
Measure of patient's adherence to medication. This adherence measurement is a composite measure
时间窗: One year after inclusion
A patient will be considered adherent if: 1. For each secondary-preventive drug (antiplatelet, lipid lowering, and antihypertensive), evaluated by the pharmacy refills: Number of days of medication available to the patient (supplied by the pharmacy divided by the total number of days in the period of the study (365)), is higher than 80%. 2. And score obtained from self-reported adherence questionnaire, greater than 6/8 is obtained for all secondary preventative medication
次要结局
- Analysis of pharmacy refills(1 year after inclusion)
- Percentage of patients with drug-related iatrogenic events(1 year after inclusion)
- Percentage of patients with a new stroke or cardiovascular event(1 year after inclusion)
- Percentage of patients readmitted in hospitalization(1 year after the inclusion)
- Realization of a questionnaire (Likert-type scale)(1 year after inclusion)
- Measure of glycemic and lipid balance.(1 year after inclusion)
- Realization of a questionnaire scoring (SF-36 scale)(1 year after inclusion)
- Realization of a questionnaire (Brief IPQR)(1 year after inclusion)
- Brief IPQR score and medication adherence (treatment adherence score and pharmacy refills) correlation (composite measure)(1 year after inclusion)
- Realization of questionnaires (Likert-type scale and SATMED) assessment of satisfaction of patients(1 year after inclusion)
- Realization of a questionnaire (Likert-type scale) assessment of satisfaction of GP and CP in relation to ADMED-AVC program.(1 year after inclusion)