To assess the utility of incorporating clinical pharmacy services in telehealth-based multidisciplinary post-acute stroke care.

Pharmacists have become a vital part of multidisciplinary teams providing clinical patient care in various healthcare settings. However, there is limited evidence of the benefits of including pharmacists in the management of stroke survivors. Pharmacist intervention in post-acute stroke care may promote equitable access and improve outcomes, especially among Black and Hispanic patients, who have a higher prevalence of uncontrolled blood pressure (BP) and limited access to physician care.

Fifty acute stroke patients with hypertension were randomized before discharge to usual care vs a telehealth-based stroke intervention including a pharmacist (Telehealth After Stroke Care, TASC)). TASC patients received a tablet to allow them to transmit blood pressure data remotely and complete video visits. The pharmacist video visit occurred at 4- and 8-weeks post-discharge to provide medication education and adjustment and adherence counseling. Process measures included the number and type of pharmacy interventions

Both cohorts of patients had similar number of medications at discharge (TASC: 9 vs. usual care: 8). In the TASC group, pharmacists made 18 interventions. These included 9 drug initiations, 6 drug modifications, 2 drug discontinuations and 1 for lab monitoring. The most common agents intervened on were diuretics, statins, and angiotensin converting enzyme inhibitors/angiotensin receptor blockers (55%, 33%, and 33%, respectively). In the usual care group, providers made seven interventions including 3 drug initiations, 3 modifications, and 1 drug discontinuation.

Incorporating clinical pharmacy services into post-acute stroke care is a feasible option that has the potential of improving patient access to care in an underserved setting. Clinical pharmacy services via telehealth may allow for timely adjustment and improved BP control.