ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Drugs Outcomes Research and Policies
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1608457
Medication Stewardship by Clinical Pharmacists in Acute Ischemic Stroke Care: A Retrospective Analysis of Drug-Related Problem Reduction and Cost-Saving Outcomes
Provisionally accepted
- Department of Pharmacy, Nanchong Key Laboratory of Individualized Drug Therapy，Beijing Anzhen Nanchong Hospital of Capital Medical University &Nanchong Central Hospita, Nanchong, Shanxi Province, China
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Background: In China's evolving Diagnosis-Intervention Packet (DIP) payment system, suboptimal medication practices in acute ischemic stroke (AIS) care exacerbate healthcare costs and antimicrobial resistance. This study evaluates the clinical and economic impacts of integrating clinical pharmacists into stroke care teams. Methods: A single-center retrospective cohort study (May–September 2024) included 439 AIS patients (clinical pharmacist care group: n = 223, standard care group n = 216). The pharmacist care group received pharmacist-led medication stewardship, including therapy optimization, adverse drug reaction (ADR) monitoring, and DIP-aligned cost management. Results: Pharmacist care significantly shortened antibiotic therapy (6.83 vs. 8.93 days, P = 0.019) and proton pump inhibitor (PPI) duration (7.29 vs. 9.50 days, P < 0.001), while reducing Ginkgolide injection use (47.53% vs. 55.56%, P = 0.043). Total hospitalization costs decreased by 10.4% ($1403 ± 595.2 vs. $1566 ± 496.0), with improved DIP settlement amount ($660.2 vs. $554.4, P = 0.001). Regression confirmed pharmacist intervention as an independent predictor of reduced costs and shorter stays. Medical staff reported high satisfaction with pharmacists' roles in medication safety (84.84%) but lower recognition of cost-saving efforts (64.19%). Conclusion: Integrating clinical pharmacists into AIS care teams reduces drug-related problems (DRPs), shortens therapy duration and hospital stays, and lowers costs, supporting broader implementation in stroke management.
Keywords: Clinical pharmacist, Acute ischemic stroke, medication stewardship, Drug-related problems, Hospitalization costs
Received: 09 Apr 2025; Accepted: 26 Sep 2025.
Copyright: © 2025 Chen, Hu, Su, Zhu, Tang, Tang and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Siyun Yang, 413305344@qq.com
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