AUTHOR=Chen Xiaoying , Hu Xiaoyan , Su Qiang , Zhu Lisha , Tang Zhiyong , Tang Chunmei , Yang Siyun 
  
TITLE=Medication stewardship by clinical pharmacists in acute ischemic stroke care: a retrospective analysis of drug-related problem reduction and cost-saving outcomes
  
JOURNAL=Frontiers in Pharmacology
  
VOLUME=Volume 16 - 2025
  
YEAR=2025
  
URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2025.1608457
  
DOI=10.3389/fphar.2025.1608457
  
ISSN=1663-9812
  
ABSTRACT=BackgroundIn 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.MethodsA 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.ResultsPharmacist 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% ($1,403 ± 595.2 vs. $1,566 ± 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%).ConclusionIntegrating 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.