Effects of Clinical Pharmacist-Led Medication Management on Medication Adherence and Quality of Life in Stroke Patients Undergoing Intravenous Thrombolysis

BACKGROUND Patients with acute ischemic stroke receiving intravenous thrombolysis require intensive secondary prevention; however, poor medication adherence and inadequate lipid control in real-world practice often compromise long-term outcomes. This study evaluated the effects of a clinical pharmacist-led medication management program on medication adherence, lipid control, and functional outcomes in patients with acute ischemic stroke receiving intravenous thrombolysis. MATERIAL AND METHODS We retrospectively analyzed data from a prospective stroke database collected between January and October 2023. Patients treated with intravenous thrombolysis were assigned to either a control group or a pharmacist-led intervention group. Outcomes included 1-month lipid profiles and low-density lipoprotein cholesterol (LDL-C) reduction, and 3-month medication adherence and clinical outcomes. RESULTS A total of 190 patients were included (93 control, 97 intervention). Baseline characteristics, including statin use and length of hospital stay, were comparable. At 1 month, the intervention group had lower LDL-C levels than the control group (2.11 [1.64-2.53] vs 2.33 [1.80-2.96] mmol/L; P=0.037) and a greater reduction from baseline (0.98 [0.38-1.46] vs 0.70 [0.22-1.31] mmol/L; P=0.044). Multivariate analysis confirmed the pharmacist-led intervention as an independent predictor of greater LDL-C reduction (ß=0.239 mmol/L; P=0.016). Medication adherence at 3 months was higher in the intervention group and independently associated with optimal adherence (adjusted OR, 3.03; 95% CI, 1.53-5.99; P=0.001). Functional outcomes did not differ significantly. CONCLUSIONS Clinical pharmacist-led medication management was associated with improved medication adherence and early lipid control in patients with acute ischemic stroke receiving intravenous thrombolysis.