A Cluster-Randomized Trial of a Centralized Clinical Pharmacy Cardiovascular Risk Service to Improve Guideline Adherence

Barry L Carter; Christopher S Coffey; Elizabeth A Chrischilles; Gail Ardery; Dixie Ecklund; Brian Gryzlak; Mark W Vander Weg; Paul A James; Alan J Christensen; Christopher P Parker; Tyler Gums; Rachel J Finkelstein; Liz Uribe; Linnea A Polgreen; MEDication Focused Outpatient Care for Underutilization of Secondary Prevention Trial Investigators

doi:10.1002/phar.1603

Journal article

A Cluster-Randomized Trial of a Centralized Clinical Pharmacy Cardiovascular Risk Service to Improve Guideline Adherence

Barry L Carter, Christopher S Coffey, Elizabeth A Chrischilles, Gail Ardery, Dixie Ecklund, Brian Gryzlak, Mark W Vander Weg, Paul A James, Alan J Christensen, Christopher P Parker, …

Pharmacotherapy, Vol.35(7), pp.653-662

07/2015

DOI: 10.1002/phar.1603

PMCID: PMC4686257

PMID: 26111939

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Abstract

Numerous studies have demonstrated the value of including pharmacists in team-based care to improve adherence to cardiovascular (CV) guidelines, medication adherence, and risk factor control. However, there is limited information on whether these models can be successfully implemented more widely in diverse settings and populations. The purpose of this study is to evaluate whether a centralized, web-based cardiovascular risk service (CVRS) managed by clinical pharmacists will improve guideline adherence in multiple primary care medical offices with diverse geographic and patient characteristics. This study is a prospective trial in 20 primary care offices stratified by the percent of under-represented minorities and then randomized to either the CVRS intervention or usual care. The intervention will last for 12 months and all subjects will have research visits at baseline and 12 months. The primary outcome is the difference in guideline adherence between groups. Data will also be abstracted from the medical record at 24 months to determine if the intervention effect is sustained after it is discontinued. Patient enrollment will continue through 2016, with results expected in 2019. This study will provide information on whether a distant, centralized CVRS can be implemented in large numbers of medical offices, if it is effective in diverse populations, and if there is a long-term sustained effect.

Guideline Adherence

Prospective Studies

Cardiovascular Diseases - prevention & control

Humans

Pharmaceutical Services

Secondary Prevention

Patient Compliance

Ambulatory Care

Details

Title: Subtitle: A Cluster-Randomized Trial of a Centralized Clinical Pharmacy Cardiovascular Risk Service to Improve Guideline Adherence
Creators: Barry L Carter - Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa
Christopher S Coffey - Department of Biostatistics, College of Public Health, Iowa City, Iowa
Elizabeth A Chrischilles - Department of Epidemiology, College of Public Health, Iowa City, Iowa
Gail Ardery - Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, Iowa
Dixie Ecklund - Department of Biostatistics, College of Public Health, Iowa City, Iowa
Brian Gryzlak - Department of Epidemiology, College of Public Health, Iowa City, Iowa
Mark W Vander Weg - Department of Psychology, College of Liberal Arts, The University of Iowa, Iowa City, Iowa
Paul A James - Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa
Alan J Christensen - Department of Psychology, College of Liberal Arts, The University of Iowa, Iowa City, Iowa
Christopher P Parker - Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, Iowa
Tyler Gums - Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, Iowa
Rachel J Finkelstein - Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, Iowa
Liz Uribe - Department of Biostatistics, College of Public Health, Iowa City, Iowa
Linnea A Polgreen - Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, Iowa
MEDication Focused Outpatient Care for Underutilization of Secondary Prevention Trial Investigators
Resource Type: Journal article
Publication Details: Pharmacotherapy, Vol.35(7), pp.653-662
DOI: 10.1002/phar.1603
PMID: 26111939
PMCID: PMC4686257
NLM abbreviation: Pharmacotherapy
ISSN: 1875-9114
eISSN: 1875-9114
Publisher: United States
Grant note: R18 HL116259 / NHLBI NIH HHS R18HL116259 / NHLBI NIH HHS
Language: English
Date published: 07/2015
Academic Unit: Pharmacy; Epidemiology; Psychological and Brain Sciences; Economics; Biostatistics; Family and Community Medicine; Pharmacy Practice and Science; Injury Prevention Research Center; Community and Behavioral Health; Internal Medicine
Record Identifier: 9983996188802771

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