Outcomes of pharmacist’s role before and after development in the fast track team for ischemic stroke patients with thrombolytic agents at Maesai hospital
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Abstract
Background: Ischemic stroke is a leading cause of disability and mortality. Enhancing the role of pharmacists in the stroke fast-track team using the 3Ds concept may improve timely access to thrombolytic agents and clinical outcomes. This study aimed to compare outcomes before and after pharmacist involvement in the stroke fast-track team.
Methods: This analytical study employed a two-group design. 1) The pre-implementation group consisted of patients receiving standard care, with retrospective data collected from October 2024 to March 2025. Following that, the pharmacist’s role was developed, and the system underwent pilot testing in April 2025. 2) The post-implementation group was prospectively collected from May to October 2025. Purposive sampling was used to recruit 32 patients per group. The instruments used were a patient data record form, disability and severity assessment forms, with reliability values of 0.84 and 0.91, respectively. Data were analyzed using descriptive statistics, including mean, standard deviation, percentage, median, interquartile range (IQR) and inferential statistics, including Chi-square test, Fisher’s exact test, Independent t-test, and Mann–Whitney U test
Results: After development, medication reconciliation increased (93.75% vs 62.50%, p=0.002) and detection of medication errors (21.88% vs 9.38%, p=0.004). The median onset-to-needle time was significantly decreased from 158 minutes to 113.50 minutes (p=0.003), and door-to-needle time decreased from 62.17 minutes to 35.39 minutes (p<0.001). The proportion of patients treated within 60, 45, and 30 minutes increased markedly. No significant differences were observed in dosing accuracy, disability outcomes, stroke severity, or complications (p>0.05).
Conclusion: Integrating pharmacists into the stroke fast-track team significantly enhanced medication safety and improved the quality of patient care.
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