Effective Application of Pharmacotherapy Strategy for Hospitalized Ischemic Stroke Patients in Malaysia
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Pharmacotherapy management, Ischemic Stroke, In-patient, Clinical Practice Guideline Malaysia
Abstract
Background:Â Worldwide, cerebrovascular accident (stroke) is the second leading cause of death and is the third leading cause of disability. Sadly, stroke prevalence in the low- and middle-income countries remains high (70%) with both stroke-related deaths and disability-adjusted life years reported to be as high as 87%.
Aim: The objective of this study is to evaluate the success of pharmacotherapy management strategy for Malaysian stroke patients in a public hospital based on the Clinical Practice Guidelines (CPG), 2012.Â
Methods:Â A retrospective, cross-sectional study based on medical records of patients (n=682) with confirmed diagnoses of ischemic stroke admitted to Sungai Buloh Hospital for four years was conducted. Data was collected using self-developed data collection forms consisting of demographic profiles, comorbidity and pharmacotherapy treatment.Â
Results:Â The mean age of reported cases was 66.66 years with the majority (58%) being males while only 42% were females. The majority (>72%) adhered to the pharmacotherapy management of Clinical Practice Guideline Malaysia 2012 for ischemic stroke inpatients setting in a public hospital (p=0.001).Â
Conclusion:Â Most patients complied to the pharmacotherapy management of ischemic stroke guideline which is important to avoid disability and mortality caused by stroke.
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References
2. Abilleira, S., Gallofré, M., Ribera, A., Sánchez, E., & Tresserras, R. (2009). Quality of in-hospital stroke care according to evidence-based performance measures. Stroke, 40(4), 1433-1438.
3. Yaghi, S., Bernstein, R. A., Passman, R., Okin, P. M., & Furie, K. L. (2017). Cryptogenic stroke: research and practice. Circulation research, 120(3), 527-540.
4. Benjamin, E. J., Muntner, P., & Bittencourt, M. S. (2019). Heart disease and stroke statistics-2019 update: a report from the American Heart Association. Circulation, 139(10), e56-e528.
5. Adamson, J., A. Beswick, et al. (2004). "Is stroke the most common cause of disability?" Journal of Stroke and Cerebrovascular Diseases 13(4): 171-177.
6. Jauch, E. C., J. L. Saver, et al. (2013). "Guidelines for the early management of patients with acute ischemic stroke." Stroke 44(3): 870-947.
7. Song, D., E. Tanaka, et al. (2015). "Factors associated with early hospital arrival in patients with acute ischemic stroke." Journal of stroke 17(2): 159
8. Greater Manchester compliance with the RCP National Clinical Guideline for Stroke, 2016. Retrieved from http://gmsodn.org.uk/wp-content/uploads/2017/03/Compliance-with-the-RCP-national-clinical-guideline-for-stroke-2016-public-version.pdf
9. Hacke, W., M. Kaste, et al. (2008). "Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke." New England Journal of Medicine 359(13): 1317-1329.
10. Caughey, G. E., A. I. Vitry, et al. (2008). "Prevalence of comorbidity of chronic diseases in Australia." BMC public health 8(1): 221.
11. Tessier, A., L. Finch, et al. (2008). "Validation of the Charlson Comorbidity Index for predicting functional outcome of stroke." Archives of physical medicine and rehabilitation 89(7): 1276-1283.
12. Clinical Practice Guideline. 2nd Edition (2012). Retrieved on 13 May 2017, from Malaysian Society of Neurosciences
13. AlSibai, A., & Qureshi, A. I. (2016). Management of acute hypertensive response in patients with ischemic stroke. The Neurohospitalist, 6(3), 122-129.
14. Wang, Y., Pan, Y., Zhao, X., Li, H., Wang, D., Johnston, S. C., ... & Wang, Y. (2015). Clopidogrel with aspirin in acute minor stroke or transient ischemic attack (CHANCE) trial: one-year outcomes. Circulation, 132(1), 40-46.
15. Kernan, W. N., Ovbiagele, B., Black, H. R., Bravata, D. M., Chimowitz, M. I., Ezekowitz, M. D., ... & Johnston, S. C. (2014). Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 45(7), 2160-2236.
16. Philip M. W. Bath, Robert Iddenden, and Fiona J. Bath (2000). Low-Molecular-Weight Heparins and Heparinoids in Acute Ischemic Stroke A Meta-Analysis of Randomized Controlled Trials. Stroke. 2000;31:1770–1778 https://doi.org/10.1161/01.STR.31.7.1770
17. Wahlgren, N., N. Ahmed, et al. (2008). "Thrombolysis with alteplase 3–4· 5 h after acute ischemic stroke (SITS-ISTR): an observational study." The Lancet 372(9646): 1303-1309.
18. Zhao W, Xiao ZJ, Zhao SP. The Benefits and Risks of Statin Therapy in Ischemic Stroke: A Review of the Literature. Neurol India 2019;67:983-92
19. Yang Z, Edwards D, Massou E, Saunders CL, Brayne C, Mant J. Statin use and high-dose statin use after ischemic stroke in the UK: a retrospective cohort study. Clin Epidemiol. 2019;11:495-508 https://doi.org/10.2147/CLEP.S201983
20. Lees, K. R., E. Bluhmki, et al. (2010). "Time to treatment with intravenous alteplase and outcome in stroke: an updated pooled analysis of ECASS, ATLANTIS, NINDS, and EPITHET trials." The Lancet 375(9727): 1695-1703.
21. Purrucker, J. C., K. Haas, et al. (2017). "Coagulation Testing in Acute Ischemic Stroke Patients Taking Non–Vitamin K Antagonist Oral Anticoagulants." Stroke 48(1): 152-158.
22. Lee, E. H. (2011). American Society of Health-System Pharmacists. Pharmacy and Therapeutics, 36(3), 159.