Pharmacists Act on Care Transitions in Stroke (PACT-Stroke): A Systems Approach

Stroke is one of the leading causes of disability in the United States. Prompt secondary prevention decreases the risk for recurrence. Pharmacists have taken a more active role in poststroke care and are initiating prompt follow-up after hospital discharge. There are, however, limited descriptions providing insight on how to implement programs that address this need. The purpose of this article is to provide insights into the development of a pharmacist-driven transitions of care program for patients with stroke. This study was a single-center, retrospective assessment of patients contacted by a pharmacist. All data were analyzed descriptively. Our initial evaluation of the Pharmacists Act on Care Transitions in Stroke (PACT-Stroke) service was to quantify and categorize drug-related problems (DRPs), which included drug selection, drug form, dose selection, treatment duration, dispensing, drug use process, patient-related problems, and other. Patients were included if they were adults who experienced an ischemic stroke. Exclusion criteria for this service included pediatric patients, patients with hemorrhagic strokes, patients with transient ischemic attacks, patients >89 years of age, pregnant patients, and patients discharged to a rehabilitation facility immediately after stroke. A total of 27 patients were included in this analysis, with a total of 30 DRPs identified. After pharmacist intervention, roughly 83% of these DRPs were resolved. Implementing secondary prevention measures for patients with stroke is crucial. A pharmacist-led transitions of care pilot program was implemented to address this high-risk patient population. This article serves as a framework for implementation at other institutions that aim to provide similar services and can potentially be applied to other high-risk groups.