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Randomized Controlled Trial
. 2018 Aug 30;8(8):e022225.
doi: 10.1136/bmjopen-2018-022225.

Use of a patient-centred educational exchange (PCEE) to improve patient's self-management of medicines after a stroke: a randomised controlled trial study protocol

Judith Ann Coombes  1   2 , Debra Rowett  3   4 , Jennifer A Whitty  1   5 , W Neil Cottrell  1
Affiliations
Randomized Controlled Trial

Use of a patient-centred educational exchange (PCEE) to improve patient's self-management of medicines after a stroke: a randomised controlled trial study protocol

Judith Ann Coombes et al. BMJ Open. .

Abstract

Introduction: National and international guidelines make recommendations for secondary prevention of stroke including the use of medications. A strategy which engages patients in a conversation to personalise evidence-based educational material (patient-centred educational exchange; PCEE) may empower patients to better manage their medications.

Methods and analysis: This protocol outlines a non-blinded randomised controlled trial. Consenting patients admitted with a diagnosis of stroke or transient ischaemic attack will be randomised 1:1 to receive either a PCEE composed of two sessions, one at the bedside before discharge and one by telephone at least 10 days after discharge from hospital in addition to usual care (intervention) or usual care alone (control). The primary aim of this study is to determine whether a PCEE improves adherence to antithrombotic, antihypertensive and lipid-lowering medications prescribed for secondary prevention of stroke over the 3 months after discharge, measured using prescription-refill data. Secondary aims include investigation of the impact of the PCEE on adherence over 12 months using prescription-refill data, self-reported medication taking behaviour, self-reported clinical outcomes (blood pressure, cholesterol, adverse medication events and readmission), quality of life, the cost utility of the intervention and changes in beliefs towards medicines and illness.

Ethics and dissemination: Communication of the trial results will provide evidence to aid clinicians in conversations with patients about medication taking behaviour related to stroke prevention. The targeted audiences will be health practitioners and consumers interested in medication taking behaviour in chronic diseases and in particular those interested in secondary prevention of stroke.The trial has ethics approval from Metro South Human Research Ethics Committee (HREC/15/QPAH/531) and The University of Queensland Institutional Human Research Ethics (2015001612).

Trial registration number: ACTRN12615000888561; Pre-results.

Keywords: academic detailing; adherence; medication; secondary prevention; stroke; stroke medicine.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Examples of proportion of days covered calculated using multiple 30-day intervals.
See this image and copyright information in PMC

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