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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This study aimed to clarify whether intensive statin therapy resulted in a significant increase in discontinuation early after discharge. METHODS: This multicenter registry study enrolled consecutive hospitalized patients with ischemic stroke or transient ischemic attack. All the patients were prescribed statin therapy at discharge. Intensity of statin therapy was defined according to the 2013 American College of Cardiology/American Heart Association guideline on the treatment of blood cholesterol. A logistic regression model was used to analyze the association between statin therapy intensity and discontinuation. ...
Source: Clinical Therapeutics - Category: Drugs & Pharmacology Authors: Tags: Clin Ther Source Type: research
Publication date: Available online 2 November 2018Source: The Lancet Diabetes &EndocrinologyAuthor(s): Marc P Bonaca, J Antonio Gutierrez, Christopher Cannon, Robert Giugliano, Michael Blazing, Jeong-Gun Park, Jennifer White, Andrew Tershakovec, Eugene BraunwaldSummaryBackgroundPolyvascular disease and type 2 diabetes are each associated with increased cardiovascular risk, but whether these risks are additive is unknown. In this exploratory analysis of a randomised trial, we explored the long-term cardiovascular risk associated with polyvascular disease, type 2 diabetes, and their combination in patients with acute cor...
Source: The Lancet Diabetes and Endocrinology - Category: Endocrinology Source Type: research
Although statins are established therapy for the secondary prevention of ischemic stroke, factors associated with adherence to statin treatment following ischemic stroke are not well known. To address this, we assessed the 6-month statin adherence using 8-item Morisky Medication Adherence Scale-8 in patients with acute ischemic stroke. Of 991 patients, 65.6% were adherent to statin at 6-month after discharge. Multiple logistic regression analysis showed that patients ’ awareness of hyperlipidemia (OR 1.62; 95% CI 1.07–2.43), large artery stroke subtype (versus non-large artery stroke, OR 1.79; 95% CI 1.19&ndash...
Source: European Neurology - Category: Neurology Source Type: research
CONCLUSIONS: The control of both LDL cholesterol and CRP levels appears to be effective for preventing recurrent stroke and TIA in patients with non-cardiogenic ischemic stroke. PMID: 30318492 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
This study aimed to assess the association between the angiopoietin-like protein 4 gene (ANGPTL4) single nucleotide polymorphisms (SNPs) and serum lipid levels, the risk of coronary artery disease (CAD) and ische...
Source: Nutrition and Metabolism - Category: Nutrition Authors: Tags: Research Source Type: research
Publication date: Available online 29 September 2018Source: American Heart JournalAuthor(s): Aruna D. Pradhan, Nina P. Paynter, Brendan M. Everett, Robert J. Glynn, Pierre Amarenco, Marshall Elam, Henry Ginsberg, William R. Hiatt, Shun Ishibashi, Wolfgang Koenig, Børge G. Nordestgaard, Jean-Charles Fruchart, Peter Libby, Paul M RidkerAbstractObservational, genetic, and experimental data indicate that triglyceride rich lipoproteins (TRLs) likely participate causally in atherothrombosis. Yet, robust clinical trial evidence that triglyceride (TG) lowering therapy reduces cardiovascular events remains elusive. The selec...
Source: American Heart Journal - Category: Cardiology Source Type: research
In conclusion, HbA1c serves as a useful marker for diagnosis and management of diabetes. AGE cannot replace HbA1c in the diagnosis and management of diabetes. There is an association of HbA1c with CVD which be mediated through modulation of CVD risk factors. PMID: 30179123 [PubMed - as supplied by publisher]
Source: Current Pharmaceutical Design - Category: Drugs & Pharmacology Authors: Tags: Curr Pharm Des Source Type: research
Conclusion These results highlight that CYP2C19*2, along with diabetes, and use of proton pump inhibitor and statin are important factors jointly associated with variability in clinical response to DAPT following ACS in Egyptians.
Source: Pharmacogenetics and Genomics - Category: Genetics & Stem Cells Tags: Original Articles Source Type: research
It is well-established that higher LDL and total cholesterol are associated with increased risk of atherosclerotic cardiovascular disease (ASCVD), that is, coronary heart disease (CHD) and ischemic stroke events, and that cholesterol-lowering by statins and other therapies reduce ASCVD risk. However, the picture is less clear for the 10% to 20% of strokes that are hemorrhagic rather than ischemic. A meta-analysis of observational studies shows that lower levels of LDL-C and total cholesterol are associated with higher risk of hemorrhagic strokes (HS), and with intracranial hemorrhage (ICH), a subset of HS.
Source: Journal of Clinical Lipidology - Category: Lipidology Authors: Tags: Editorial Source Type: research
Statins improve clinical outcomes in patients with ischemic stroke but there is no evidence of the effect of continuing long-term statin therapy in patients with intracerebral hemorrhage (ICH). The aim of this study was to evaluate the impact of continuing statin after ICH.
Source: Atherosclerosis - Category: Cardiology Authors: Source Type: research
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