2020 Volume 23 Issue 4 Pages 600-607
Background: At Musashino Red Cross Hospital in Tokyo Japan, there is a system for the early treatment of patients with stroke. When a patient with a suspected stroke is identified by the emergency service or physicians in the region, a pre-arrival alert is directed to the medical stroke specialist. The physician subsequently activates the stroke team. This system is termed Stroke Care Unit Hotline. Although there are no pharmacists in the emergency department, following the activation of Stroke Care Unit Hotline, pharmacists working in the ward of Stroke Care Unit join the stroke treatment team in the emergency department. Purpose: The aim of this study was to determine the role and effects of pharmacists on rtPA therapy for patients with acute ischemic stroke. Methods: The present retrospective study was comparison of the door-to-rtPA time between the pharmacist-present group and pharmacist-absent group at Musashino Red Cross Hospital between March 1, 2016 and March 31, 2019. And the effects of pharmacists’ activities on rtPA therapy were investigated. Results: Among the 447 patients diagnosed with ischemic stroke, 63 patients received rtPA therapy. In total, 16 and 47 patients were included in the pharmacist-present group and pharmacist-absent group, respectively. The median door-to-rtPA time in the presence and absence of a pharmacist was 74 min and 89 min, respectively (p=0.01). At 24 h post-rtPA, the National Institutes of Health Stroke Scale (NIHSS) showed a significant decrease in the pharmacist-present group. Moreover, following patient discharge, the modified Rankin Scale (mRS) was markedly decreased in the pharmacist-present group. Discussion: The interventions of a pharmacist who did not belong to the emergency department shortened the door-to-rtPA time for patients with acute ischemic stroke. This study suggested that the rapid confirmation of medical information by the pharmacist is linked to the early administration of rtPA therapy. Also, the study showed that the early intervention of the pharmacist may improve the quality of life of the patients. The increased intervention of pharmacist who has a specialty of each field may be beneficial to emergency care teams and patient care.
