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Multiprofessional intervention to improve adherence to medication in stroke patients: a study protocol for a randomised controlled trial (ADMED AVC study)
  1. Sophie Khettar1,2,
  2. Sophie Jacquin Courtois3,4,
  3. Jacques Luaute3,4,
  4. Evelyne Decullier5,
  5. Sylvie Bin5,
  6. Marine Dupuis5,
  7. Laurent Derex6,7,
  8. Laura Mechtouff7,8,
  9. Norbert Nighoghossian7,9,
  10. Claude Dussart2,
  11. Gilles Rode3,4,
  12. Audrey Janoly-Dumenil1,2
  1. 1 Department of Pharmacy, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
  2. 2 EA 4129 P2S Parcours Santé Systémique, Claude Bernard University Lyon 1, Lyon, France
  3. 3 Physical medicine and rehabilitation department, Henry Gabrielle Hospital, Hospices Civils de Lyon, Saint-Genis-Laval, France
  4. 4 INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center, ImpAct Team, Claude Bernard University Lyon 1, Bron, France
  5. 5 Public Health Center, Research and Clinical Epidemiology, Hospices Civils de Lyon, Lyon, France
  6. 6 EA 7425 HESPER Health Services and Performance Research, Claude Bernard University Lyon1, Lyon, France
  7. 7 Stroke center, Pierre Wertheimer Hospital, Hospices Civils de Lyon, Bron, France
  8. 8 INSERM U1060, CarMeN laboratory, Claude bernard University Lyon 1, Villeurbanne, France
  9. 9 INSERM U1044, CNRS UMR 5220, CREATIS, Claude Bernard University Lyon 1, Villeurbanne, France
  1. Correspondence to Dr Sophie Khettar, EA 4129 P2S Parcours Santé Systémique, Faculté de Médecine Laënnec, 7-11 rue Guillaume Paradin 69372 Lyon cedex 08, France; sophie.khettar{at}chu-lyon.fr

Abstract

Introduction Adherence to secondary preventive medications is often suboptimal in patients with stroke, exposing them to an increased risk of recurrent cerebral and/or cardiovascular events. Effective actions in the long term to improve adherence to medication are needed. The study will evaluate the efficacy of a collaborative multiprofessional patient-centred intervention conducted by a pharmacist on adherence to secondary preventive medication in stroke survivors.

Methods and analysis This is a multicentre cluster-randomised controlled trial. Two groups of 91 patients (intervention vs standard care) will be recruited. The clinical pharmacist intervention targeting secondary preventive medication will consist of three parts over 1 year: (1) an individual semi-structured interview at hospital discharge; (2) follow-up telephone interviews at 3, 6 and 9 months after discharge; and (3) a final individual semi-structured interview 1 year after discharge. Information on patient follow-up will be shared with the general practitioner and the community pharmacist by sending a report of each interview. The primary outcome is adherence to medication during the 12 months after hospital discharge, assessed using a composite endpoint: the medication possession ratio associated with a self-administered questionnaire.

Ethics and dissemination The local ethics committee, the national committee for use of personal data in medical research and the national data protection agency approved the study. The sponsor has no role in study design; collection, analysis and interpretation of data; or report writing.

Discussion This pharmacist-led educational programme has the potential to significantly improve adherence to medication in stroke survivors which could lead to a decrease in recurrent cerebral and/or cardiovascular events.

Trial registration number NCT02611440

  • stroke
  • randomized controlled trial
  • education
  • pharmacy
  • pharmacy service
  • hospital
  • physical and rehabilitation medicine

Data availability statement

There are no data in this work.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, an indication of whether changes were made, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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