PMID- 26412104
OWN - NLM
STAT- MEDLINE
DCOM- 20160930
LR  - 20181113
IS  - 0736-4679 (Print)
IS  - 0736-4679 (Linking)
VI  - 50
IP  - 1
DP  - 2016 Jan
TI  - Pharmacist Impact on Ischemic Stroke Care in the Emergency Department.
PG  - 187-93
LID - 10.1016/j.jemermed.2015.07.040 [doi]
LID - S0736-4679(15)00815-X [pii]
AB  - BACKGROUND: The Froedtert Acute Stroke Team (FAST) is composed of various health 
      professionals who respond to stroke calls, but it does not formally include a
      pharmacist at this time. However, emergency department (ED) pharmacists have been
      actively involved in patient evaluation and facilitation of i.v. recombinant
      tissue plasminogen activator (rtPA) preparation and administration in the ED. ED 
      pharmacists are qualified to dose and prepare rtPA, as well as screen for
      contraindications to therapy. OBJECTIVE: The primary objective was to compare the
      accuracy of rtPA dosing, mean door-to-rtPA time, and identification of
      contraindications to rtPA therapy when a pharmacist was present vs. absent in the
      ED. METHODS: This is a retrospective study of 105 patients who received rtPA for 
      acute ischemic stroke in the ED at a comprehensive stroke center from January 1, 
      2008 to October 1, 2012. RESULTS: A total of 105 patients were included in this
      study. Dosing accuracy was similar when a pharmacist was present vs. absent
      (96.6% vs. 95.6%; p = 0.8953). The median door-to-rtPA time when a pharmacist was
      present was statistically significantly shorter than when a pharmacist was absent
      (69.5 vs. 89.5 min; p = 0.0027). When a pharmacist was present, a door-to-rtPA
      time of < 60 min was achieved 29.9% of the time, as compared with 15.8% in the
      pharmacist-absent group (p = 0.1087). CONCLUSIONS: Pharmacist involvement on
      stroke teams may have a beneficial effect on door-to-rtPA time and patient care
      in the ED.
CI  - Copyright (c) 2016 Elsevier Inc. All rights reserved.
FAU - Gosser, Rena A
AU  - Gosser RA
AD  - Department of Pharmacy, Froedtert & the Medical College of Wisconsin, Milwaukee, 
      Wisconsin.
FAU - Arndt, Richard F
AU  - Arndt RF
AD  - Department of Pharmacy, Froedtert & the Medical College of Wisconsin, Milwaukee, 
      Wisconsin.
FAU - Schaafsma, Kate
AU  - Schaafsma K
AD  - Department of Pharmacy, Froedtert & the Medical College of Wisconsin, Milwaukee, 
      Wisconsin.
FAU - Dang, Cathyyen H
AU  - Dang CH
AD  - Department of Pharmacy, Froedtert & the Medical College of Wisconsin, Milwaukee, 
      Wisconsin.
LA  - eng
GR  - UL1 TR000055/TR/NCATS NIH HHS/United States
GR  - 8UL1TR000055/TR/NCATS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20150926
PL  - United States
TA  - J Emerg Med
JT  - The Journal of emergency medicine
JID - 8412174
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Recombinant Proteins)
RN  - EC 3.4.21.68 (Tissue Plasminogen Activator)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Brain Ischemia/*drug therapy
MH  - Delivery of Health Care/standards
MH  - Emergency Service, Hospital/*organization & administration
MH  - Female
MH  - Fibrinolytic Agents/*therapeutic use
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pharmacy Service, Hospital/*organization & administration
MH  - Recombinant Proteins/therapeutic use
MH  - Retrospective Studies
MH  - Stroke/*drug therapy
MH  - Thrombolytic Therapy/*methods
MH  - Time Factors
MH  - Tissue Plasminogen Activator/*therapeutic use
PMC - PMC4878398
MID - NIHMS786655
OTO - NOTNLM
OT  - alteplase
OT  - ischemic stroke
OT  - pharmacist
OT  - recombinant tissue plasminogen activator
OT  - rtPA
EDAT- 2015/09/29 06:00
MHDA- 2016/10/01 06:00
CRDT- 2015/09/29 06:00
PHST- 2015/03/15 00:00 [received]
PHST- 2015/06/29 00:00 [revised]
PHST- 2015/07/25 00:00 [accepted]
PHST- 2015/09/29 06:00 [entrez]
PHST- 2015/09/29 06:00 [pubmed]
PHST- 2016/10/01 06:00 [medline]
AID - S0736-4679(15)00815-X [pii]
AID - 10.1016/j.jemermed.2015.07.040 [doi]
PST - ppublish
SO  - J Emerg Med. 2016 Jan;50(1):187-93. doi: 10.1016/j.jemermed.2015.07.040. Epub
      2015 Sep 26.