Providing systematic detailed information on medication upon hospital discharge as an important step towards improved transitional care

The objectives were to develop a structured medication report as part of the discharge letter, to evaluate the impact of the medication report in ischaemic stroke patients and to identify the most important issues in the transitional care process of stroke patients. MethodsFirst, a structured medication report was developed. Thereafter, the impact of this new medication report on clinical practice was evaluated with an open, prospective, interventional two‐phase study conducted at the Klinikum Fulda gAG (Germany), which included patients with ischaemic stroke and>2 drugs in the discharge medication. In the control group (CG), the neurologist included the current medication in the discharge letter. In the intervention group (IG), the clinical pharmacist added the detailed information to a medication report. To evaluate adherence to discharge medication, the PCP was interviewed 3 months after hospital discharge about the medication. Adherence was measured with respect to the entire medication regimen, antithrombotic and cholesterol‐lowering drugs and discontinued medication. The most important issues in the transitional care for patients with ischaemic stroke were identified on the basis of the secondary stroke prevention and cardiovascular risk factors. Results and discussionOverall, 312 patients were enrolled in the study with 156 patients in each group. By providing detailed information in the newly developed discharge letter, adherence increased significantly fr...
Source: Journal of Clinical Pharmacy and Therapeutics - Category: Drugs & Pharmacology Authors: Tags: Original Article Source Type: research

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AbstractPurpose of reviewAs one of the fastest growing portions of the population, nonagenarians will constitute a significant percentage of the stroke patient population in the near future. Nonagenarians are nevertheless not specifically targeted by most clinical guidelines. In this review, we aimed to summarise the available evidence guiding stroke prevention and treatment in this age group.Recent findingsSeveral recent observational studies have shown that the benefits of anticoagulation for the oldest old patients with atrial fibrillation may outweigh the bleeding risk. A sub-analysis of the IST-3 trial has shown for t...
Source: Current Treatment Options in Neurology - Category: Neurology Source Type: research
Authors: Kirkpatrick AC, Vincent AS, Dale GL, Prodan CI Abstract Coated-platelets are a subset of highly procoagulant platelets elevated in patients with non-lacunar ischemic stroke and associated with stroke recurrence. Cross-sectional studies in controls have shown that smoking is associated with higher coated-platelet levels while chronic use of serotonin reuptake inhibitors (SSRIs), statins or aspirin is associated with lower coated-platelet levels. We now investigate if initiation of treatment with SSRIs, statins, clopidogrel, aspirin or oral anticoagulants and smoking cessation impacts coated-platelet levels ...
Source: Platelets - Category: Hematology Tags: Platelets Source Type: research
Background and purpose: Previous studies have shown that common variants within CYP3A4 and CYP3A5 are associated with statin pharmacokinetics and the risk of cardiovascular disease. However, the association of variants in CYP3A4 and CYP3A5 with the prognosis of ischemic stroke remains undetermined. Therefore, we investigated this herein. Methods: Four hundred thirty-three consecutive patients with acute ischemic stroke were recruited. The outcome at the 1-year follow-up was assessed using the modified Rankin Scale (mRS).
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research
CONCLUSIONS: The enlargement of calcifications in carotid plaques is the only calcification parameter important for the clinical outcome of carotid atherosclerosis. Patients with calcified carotid plaques have a significantly lower risk of ischemic stroke than patients with non-calcified lesions. PMID: 31038189 [PubMed - in process]
Source: Folia Neuropathologica - Category: Pathology Authors: Tags: Folia Neuropathol Source Type: research
Conclusion: This study suggests that a clinically efficacious cardiovascular Chinese herbal medicine (DLP) can be successfully repurposed to treat a lung disease in pulmonary fibrosis guided by TCM theory. Our comparative study between DLP and DHP demonstrated a critical requirement of suppressing both pro-inflammatory and pro-fibrotic pathways for the treatment of pulmonary fibrosis, supporting that a multi-component prescription capable of “removing both phlegm and blood stasis” will better achieve co-protection of heart and lung in PHD. Introduction Idiopathic pulmonary fibrosis (IPF) is a chronic an...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
In the Reduction of Cardiovascular Events with Icosapent Ethyl –Intervention Trial (REDUCE-IT) [1], among patients with elevated triglycerides on statins, ischemic event risk was lower among those who received icosapent ethyl vs. placebo. However, while coronary events were reduced in both REDUCE-IT and another pure EPA trial, Japan EPA lipid intervention stu dy (JELIS) [2], ischemic stroke risk was lowered in REDUCE-IT (HR 0.64, 0.49-0.85), but not decreased in JELIS (HR 0.97, 0.85-1.10). The discrepancy between these two pure EPA trials might be due to the varied race-ethnicity composition of participants, since pa...
Source: Journal of the Neurological Sciences - Category: Neurology Authors: Tags: Letter to the Editor Source Type: research
Remnant Lipoproteins Are Residual Risk Factor for Future Cardiovascular Events in Patients With Stable Coronary Artery Disease and On-Statin Low-Density Lipoprotein Cholesterol Levels
Source: Circulation Journal - Category: Cardiology Authors: Tags: Circ J Source Type: research
Giuseppe Ristagno1*, Francesca Fumagalli1, Barbara Bottazzi2, Alberto Mantovani2,3,4, Davide Olivari1, Deborah Novelli1 and Roberto Latini1 1Department of Cardiovascular Research, Mario Negri Institute for Pharmacological Research IRCCS, Milan, Italy 2Humanitas Clinical and Research Center-IRCCS, Milan, Italy 3Humanitas University, Milan, Italy 4The William Harvey Research Institute, Queen Mary University of London, London, United Kingdom The long pentraxin PTX3 is a member of the pentraxin family produced locally by stromal and myeloid cells in response to proinflammatory signals and microbial moieties. The p...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. Introduction Transcranial Doppler (TCD) detected microembolism in the ipsilateral middle cerebral artery (MCA) may help stratify the risk of stroke and other arterial disease complications in persons with advanced (≥60%) asymptomatic carotid stenosis. If so, this techniqu...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Reducing residual cardiovascular risk in patients treated with statins and having hypertriglyceridemia was addressed by Reduction of Cardiovascular Events with Icosapent Ethyl–Intervention Trial (REDUCE-IT) [1]. REDUCE-IT was a double blind placebo controlled multicenter randomized trial. Patients with established cardiovascular disease or diabetes mellitus with other risk factors treated with statins were evaluated. At study inclusion they needed to have fasting triglyceride levels between 135 and 499 mg/dL and LDL cholesterol level 41 to 100 mg/dL. They were randomized to either 2 g of icosapent ethyl twice ...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology Source Type: blogs
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