Effects of Telepharmacy in Post Ischemic Stroke Patients: A Randomized Controlled Trial.

IF 0.9 Q4 PHARMACOLOGY & PHARMACY

Hospital Pharmacy Pub Date : 2026-03-27 DOI:10.1177/00185787261423000

Arworn Chaemkiri, Thutcha Thienpanja, Teeraporn Sadira Supapaan, Nonglek Kunawaradisai

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引用次数: 0

Abstract

Purpose: To compare pharmacist-led telepharmacy with standard pharmaceutical care on stroke and medication knowledge, medication adherence, and clinical outcomes (blood pressure [BP], low-density lipoprotein cholesterol [LDL-C], and glycated hemoglobin [HbA1c]) in patients with post-ischemic stroke; and to characterize medication-related problems (MRPs) and their severity in the telepharmacy arm.

Methods: In a randomized controlled trial, 126 hospitalized adults with ischemic stroke were assigned 1:1 to receive either standard pharmaceutical care alone or standard care plus structured telepharmacy follow-ups at 1 week, 1, and 2 months post-discharge (n = 63/arm). Outcomes were assessed using validated tools, including knowledge questionnaires; the Medication Adherence Scale for Thais (MAST); the Pharmaceutical Care Network Europe (PCNE); classification v9.1; and the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) severity index.

Results: Compared with controls, telepharmacy improved post-discharge knowledge (11.75 ± 2.38 vs 9.79 ± 2.43; P < .001) and adherence (MAST 37.00 ± 3.45 vs 33.26 ± 3.76; P < .001). BP target attainment (<130/80 mmHg) was higher with telepharmacy (52.4% vs 30.2%; P = .011). Follow-up BP favored telepharmacy: systolic Δ -3.67 mmHg (95% CI -6.79 to -0.55; P = .041) and diastolic Δ -3.11 mmHg (95% CI -5.99 to -0.23; P = .040). Between-group differences were not significant for LDL-C or HbA1c. In the telepharmacy arm, 76 MRPs were identified; the most frequent problem was unnecessary drug treatment (38.16%), commonly due to patients' decision to use unnecessary drugs (28.93%). Patient counseling was the commonest intervention (40.00%); 83.64% were fully implemented and 92.10% of MRPs were completely resolved. An ~36.84% of MRPs were NCC MERP level E.

Conclusions: Telepharmacy improved knowledge, medication adherence, and BP control after ischemic stroke, and enabled effective identification and resolution of MRPs. These findings support incorporating pharmacist-led telepharmacy into post-discharge transitional care pathways. The trial was retrospectively registered (TCTR20250401004). https://www.thaiclinicaltrials.org/show/TCTR20250401004.

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远程药房对缺血性脑卒中后患者的影响：一项随机对照试验。

目的：比较药师主导的远程药学服务与标准药学服务在缺血性卒中后患者卒中及用药知识、用药依从性和临床结局（血压[BP]、低密度脂蛋白胆固醇[LDL-C]、糖化血红蛋白[HbA1c]）方面的差异；并描述远程药房的药物相关问题（mrp）及其严重程度。方法：在一项随机对照试验中，126例缺血性脑卒中住院成人按1:1分配，分别在出院后1周、1和2个月接受标准药物治疗或标准治疗加结构化远程药房随访（n = 63/组）。使用经过验证的工具评估结果，包括知识问卷；泰国人药物依从性量表（MAST）；欧洲药品保健网络（PCNE）；分类v9.1;以及国家药物错误报告和预防协调委员会（NCC MERP）严重程度指数。结果：与对照组相比，远程药房提高了出院后知识水平（11.75±2.38 vs 9.79±2.43;P P P = 0.011）。随访血压有利于远程药房：收缩压Δ -3.67 mmHg (95% CI -6.79 ~ -0.55; P =。041)和舒张Δ -3.11 mmHg （95% CI -5.99 ~ -0.23; P = 0.040）。LDL-C和HbA1c组间差异无统计学意义。在远程药房部门，确定了76个mrp；最常见的问题是不必要的药物治疗（38.16%），主要是由于患者决定使用不必要的药物（28.93%）。患者咨询是最常见的干预措施（40.00%）；83.64%完全实施，92.10%的mrp完全解决。结论：远程药房提高了缺血性脑卒中患者的知识水平、服药依从性和血压控制，能够有效地识别和解决mrp。这些发现支持将药剂师主导的远程药房纳入出院后过渡护理途径。该试验回顾性注册（TCTR20250401004）。https://www.thaiclinicaltrials.org/show/TCTR20250401004。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hospital Pharmacy PHARMACOLOGY & PHARMACY-

CiteScore

1.70

自引率

0.00%

发文量

期刊介绍： Hospital Pharmacy is a monthly peer-reviewed journal that is read by pharmacists and other providers practicing in the inpatient and outpatient setting within hospitals, long-term care facilities, home care, and other health-system settings The Hospital Pharmacy Assistant Editor, Michael R. Cohen, RPh, MS, DSc, FASHP, is author of a Medication Error Report Analysis and founder of The Institute for Safe Medication Practices (ISMP), a nonprofit organization that provides education about adverse drug events and their prevention.