Abstract TP208: Feasibility of a "Psychologically Smart" Community Pharmacy Intervention to Improve Patient Recognition and Response Time in Stroke

Abstract

Background: Evaluations of public health campaigns demonstrate that stroke symptom knowledge is necessary but not sufficient for timely patient activation of emergency services in acute stroke. Incorporating behavioral and psychological factors into stroke preparedness interventions may reduce pre-hospital delay. Methods: We developed and tested the feasibility of patient-based educational interventions “Control Stroke” (CS) and CS plus self-affirmation, in two pharmacies. The interventions drew on theory and methods in psychology and behavioral science, including self-affirmation and self-regulation theories. We enrolled 50 higher risk subjects, defined as age > 50 and having prescriptions for at least two drugs across 7 stroke-associated conditions. Consecutive patients were randomized to receive the (CS) intervention or CS plus self -affirmation, a strategy that reduces defensive message processing. Using a survey, we measured satisfaction with the intervention, openness to its message, self-efficacy, and knowledge of stroke symptoms immediately post-intervention and at 1 month. Results: We recruited 28 female and 22 male subjects over eight weeks. 86% of participants completed the 1-month survey. 45% of subjects were over 75 years old. CS took 10-15 minutes to complete. Satisfaction with the intervention was high: mean net promoter score was 8.9 (of 10) (CI 8.4,9.5); 96% (CI 86,99) were satisfied or completely satisfied with the program; 96% (CI 86,99) felt the session was useful, and 100% reported the information was clear and easy to understand. Stroke symptom knowledge on the validated Stroke Action Test was comparable to other stroke education studies. There was a trend towards persistence of some program benefits in the one month follow up in the CS + self-affirmation group. Conclusion: It was feasible to recruit community pharmacy subjects to participate in a brief educational intervention for stroke. Participants reported high likelihood to recommend, easy to understand content, and symptom knowledge comparable to other studies. Self-affirmation showed evidence of prolonging some benefits. Future work will validate this in a larger population intervention and measure impact in simulated stroke scenarios.