Abstract
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% ($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%). 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.