Integration of a Pharmacist into a Stroke Prevention Clinic Team: CLINIC INFORMATION
The David Thompson Health Region (DTHR) serves about 300 000 people in central Alberta. Within the DTHR, pharmacists are members of the acute stroke team and had participated in the Acute Stroke Management Working Group at the primary referral hospital. Neurologists, nurses, and other members of the stroke team have welcomed the addition of a pharmacist to each of these areas of stroke management.
In 2005, the DTHR opened a Stroke Prevention Clinic to provide treatment and education for residents of central Alberta who have had a cerebrovascular event. The objectives of the clinic are to aggressively manage risk factors and lifestyle behaviours with the ultimate goal of reducing the risk of recurrent stroke, as outlined in the Alberta Provincial Stroke Strategy. Anticoagulation management is not performed in the clinic; instead, patients needing this type of therapy are referred elsewhere in the region.
cialis soft tabs
Any patient who experiences a cerebrovascular event within the DTHR is eligible for follow-up at the clinic by physician referral. Patients who have been treated for a cerebrovascular event at the DTHR’s primary referral hospital are placed on an appropriate management protocol within the hospital (e.g., the DTHR Transient Ischemic Attack Protocol or the DTHR Stroke Protocol). Each of these protocols suggests that patients be referred to the Stroke Prevention Clinic. Physicians may also refer to the clinic patients who have experienced a cerebrovas- cular event outside the hospital. At the time of this study, patients were followed by clinic staff for 6 months, although the number of visits varied between patients. If a patient experiences another event, he or she may be followed for longer than 6 months. Patients are not seen in the clinic if they refuse follow-up or if they have significant residual morbidities from the stroke that would prevent them from participating, such as severe deficit requiring long-term care.
Initially, neurologists, registered nurses, a social worker, a dietitian, and an administrative assistant staffed the clinic, with later addition of a pharmacist. The clinic nurses expressed concern over their ability to fully educate patients about the safe and appropriate use of medications. They requested educational presentations by the acute stroke pharmacists on the medications used in stroke management and prevention. They also consulted the acute stroke pharmacists about various pharmacotherapy issues.
The proposal to add a pharmacist to the clinic team was seen as a way to ensure the availability of someone who could fully educate patients about their medications while assisting clinic staff in their educational endeavours and providing pharmaceutical care to patients. Integration of a pharmacist into the Stroke Prevention Clinic team represented a natural progression of the stroke services offered by clinical pharmacists within the DTHR. canadian cialis
