Abstract P264: Medication Coaching for Secondary Prevention Adherence in Stroke Patients: A Pilot Study

Objective: Education about stroke prevention medications after discharge is suboptimal. Our aim was to assess feasibility of a telephone intervention designed to provide education and coaching about medications and/or stroke recovery following hospital discharge. Methods: We performed a two-arm pilot study of patients admitted with ischemic or hemorrhagic stroke or TIA who had at least 2 medications changed between admission and discharge. The intervention was a telephone contact from a medication coach (study coordinator) about 2 weeks after discharge and included reviewing each medication on the participant's discharge list, assessing his/her understanding about the medication's purpose, how to take it, refill it, and its side effects. Patients were then asked if they had any specific questions about their medications or stroke recovery. The coach triaged medication-related questions to a pharmacist and stroke-related questions to a stroke nurse, compiled responses, and called the patient back with the information. Results: Thirty patients were enrolled, (intervention n=20, 12 women; and control n=10, 4 women) and we report results for 29 patients. Age, gender, stroke severity, socioeconomic status, and number of discharge medications were similar in both groups. In the intervention group, 7 of 19 patients stated the correct reason for all prescribed prevention medications and 9 could state the reason for 50% or more. None could identify side effects for all prescribed medications and 5 were unable to list any medication side effects. Eleven of the 19 patients (58%) in the intervention group had questions for the pharmacist or nurse (range1 to 5 questions per patient). More women (7 of 11) requested information than men (4 of 11; p=0.017). The median number of calls required to complete the intervention was 2 (range 1 to 9). The median lengths of the coaching and follow-up calls with requested answers to questions were 27 minutes and 12 minutes, respectively. Conclusion: This medication coaching pilot study performed early after discharge demonstrated feasibility of coaching and educating stroke patients using pharmacy and nurse consultation, via a coach. Larger studies are needed to determine the impact of this intervention on medication adherence.