Program

CO32-007

Oral Communication

From design in rehabilitation units to the application in a community pharmacy of a pharmaceutical interview for stroke survivors: results of a pilot study

Ms Sophie KHETTARa, Dr Delphine LALAUa, Dr David THIERRYb, Dr Jacques LUAUTEa, Prof Sophie JACQUIN COURTOISa, Prof Gilles RODEa, Dr Audrey JANOLY DUMENILa

a Hôpital Henry Gabrielle, b Pharmacie Martin Pinel, Pont de Cheruy

Introduction:

After stroke preventive treatments are a primary determinant to avoid a recurrent cardiovascular event. However, patient’s adherence to long-term treatment is quite low [1]. Collaborative with healthcare providers, the pharmaceutical intervention already showed impact on drug therapy (pharmaceutical care concept). This concept is established in Canada for a long time, and begin to emerge in Europe [2].

Objective:

To develop pharmaceutical interviews with stroke survivors in hospital, and to bring this approach to community pharmacies.

Methods:

Individual semi-guided interviews were conducted in two steps: (a) evaluation of patient’s knowledge, skills and self-care ; (b) providing an appropriate structured information according to patient’s needs. For (a) a specific questionnaire incorporating problems relating to generic drugs and hygiene and dietary follow-up was developed ; educational tools were used for (b): picture book, packages of drugs. At the end of the interview, information sheets and a management plan “how to take treatments” were given. This approach, developed in neurological rehabilitation unit, was then used in community pharmacy with ambulatory patients to test practicability of the method.

Results:

A total of 26 interviews were conducted: 20 inpatients and 6 outpatients. (a) The level of drug knowledge varies and no difference between the two groups was observed. Some notions are well known such as treatment start-up date (respectively 85 and 83%), management plan of treatments (60 and 67%). On the other hand, therapeutic indication of treatment (40 and 33%), what to do in risk situations (37 and 33%) or in the case of adverse event (11 and 0%), and hygiene and dietetic rules (45 and 33%) were less known. (b) Patients were very satisfied with the counselling interview.

Discussion:

Interviews with ambulatory patients confirmed the feasibility of this approach first developed at the hospital. Patient’s knowledge remains partial, including patients treated for a long time. It is now necessary to assess the impact of this pharmaceutical intervention on long term health care’s quality.

[1]: Sabate E World Health Organization, 2003 ; [2] : Hohman C - Health Qual Life Outcomes. 2010 ; 18:59.

Keywords : stroke, medication adherence, pharmaceutical care, patient’s interview, knowledge