ArticleFrontiers in neurology
A multicomponent intervention incorporating CYP2C19 genotype-guided therapy and integrated pharmaceutical care reduces hospitalizations and improves adherence in ischemic stroke.
Article in Frontiers in neurology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: In ischemic stroke patients, antiplatelet therapy faces challenges from CYP2C19 genetic variability and poor post-discharge medication adherence, yet the value of integrating genotyping with comprehensive pharmaceutical care remains unclear across different recurrence risk populations. Methods: This single-center, prospective, parallel-group, open-label, assessor-blinded randomized controlled trial enrolled 300 ischemic stroke patients to evaluate a complex pharmacist-led intervention incorporating CYP2C19 genotype-guided antiplatelet therapy (individualized group, Results: In the individualized treatment group, the proportion of patients with intermediate or poor CYP2C19 metabolizer phenotypes who received antiplatelet therapy adjustments was significantly higher (48.72 and 77.27% vs. 10.00%, Conclusion: A multicomponent intervention comprising CYP2C19 genotype-guided therapy and intensive pharmacist-led integrated pharmaceutical care significantly improved medication adherence and reduced hospitalization frequency, with more pronounced benefits observed in patients at high risk of stroke recurrence, without increasing the risk of adverse drug reactions. However, the specific contribution of genotyping alone cannot be isolated from the overall care package.
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