Drug Utilization Pattern and Role of Clinical Pharmacist in Medication Adherence of Stroke Patients in a Tertiary Care Hospital, South India: A Prospective Observational Study

Abstract

Stroke comprises of a broad term encompassing many disorders of the blood vessels of the central nervous system that may result from either inadequate blood flow to the brain with subsequent infarction of the involved portion of the CNS or haemorrhages into the parenchyma or subarachnoid space of the CNS causing neurologic dysfunction. Stroke is one of the major cause of mortality worldwide. The objective of the study was to assess the drug utilization pattern (DUP) and to evaluate the impact of counseling on medication adherence for stroke patient admitted in the hospital. Dual antiplatelet therapy (69.4%) was mostly given over monotherapy (28.2%). CCB (28.2%) was the most commonly prescribed antihypertensive drug class and amlodipine (77.1%) was the major CCB given in this study. 96.5 prescriptions comply AHA/ASA guidelines. Unintentional reasons for nonadherence were been reported more frequently than intentional reasons prior to the counseling. The commonest reported unintentional reasons were Forgetfulness (96.0%), Confusion (80.0%) and intentional reasons are carelessness (92%), avoiding dosing schedule (78%). Medication adherence before and after counseling was compared and was found to be improved with a statistically significant (p<0.01). In our study most patients with hypertension, diabetes mellitus and hyperlipidemia were the victims of the stroke. An equal preponderance of both the gender was observed. Our study identified unintentional reasons for non-adherence were more common than intentional non-adherence.