Health-Related Quality of Life after Ischemic Stroke: The Impact of Pharmaceutical Interventions on Drug Therapy (Pharma
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RESEARCH
Health-Related Quality of Life after Ischemic Stroke: The Impact of Pharmaceutical Interventions on Drug Therapy (Pharmaceutical Care Concept) Research
Carina Hohmann*1,2, Roland Radziwill2, Juergen M Klotz1 and Andreas H Jacobs3
Abstract Background: Health-related quality of life (HRQoL) after stroke is an important healthcare measure. Pharmaceutical Care (PC) is an evolving concept to optimize drug-therapy, minimize drug-related problems, and improve HRQoL of patients. The purpose of this study was to evaluate the impact of PC on HRQoL, as determined by Short Form 36 (SF36) among patients after TIA or ischemic stroke one-year following their initial entry in hospital. Methods: Patients were assigned to either an intervention (IG) or a control group (CG). The individual assignment of the patient to IG or CG depended on the community pharmacy to which the patients were assigned for care. Community pharmacies either delivered standard care (CG) or provided intensified PC (IG). Pharmacists who are members of the "Quality Assurance Working Group" (QAWG) provided PC for patients in IG. Results: 255 patients were recruited (IG: n = 90; CG: n = 165) between 06/2004 to 01/2007. During the study, the HRQoL of the patients in IG did not change significantly. In the CG, a significant decrease in the HRQoL was observed in 7/8 subscales and in both summary measures of SF-36. Conclusions: This is the first follow-up study in Germany involving a major community hospital, rehabilitation hospitals, community pharmacies and general practitioners investigating the impact of PC on HRQoL of patients after ischemic stroke. Our findings indicate that an intensified education and care of patients after ischemic stroke by dedicated pharmacists based on a concept of PC may maintain the HRQoL of IG patients. Background Stroke is one of the leading causes of death in Europe and the major cause of disability in the elderly [1,2]. Healthrelated quality of life (HRQoL) related to stroke and life satisfaction after stroke are important healthcare outcomes that have not received sufficient attention in the literature. HRQoL assessment includes at least 4 dimensions: physical, functional, psychological, and social health [3,4]. The physical health dimension refers to disease-related symptoms. The functional health comprises self-care, mobility, and the capacity to perform various familiar and work roles. The psychological dimension includes cognitive and emotional functions and subjective perceptions of health and life satisfaction. The social dimension includes social and familiar contacts [3]. Short * Correspondence: [email protected] 1
Klinikum Fulda gAG, Department of Neurology, Pacelliallee 4, 36043 Fulda, Germany
Form 36 is a widely and frequently used, generic, patientreport instrument for measuring quality of life [5]. It has also been validated in patients with stroke [5,6]. Pharmaceutical Care (PC), first outlined by Hepler and Strand in 1990, has been the subject of intensive research in Germany
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