Pharmacist Enhanced Service for Cardiovascular Risk Reduction

Monash University

Status: Withdrawn

Conditions: Cardiovascular Risk Factor

Treatments: Other: Usual care; Other: Enhanced pharmacist service

Study type: Interventional

Funder types: Other

Identifiers

NCT04220788

PxES-CAR2+

Details and patient eligibility

About

Pharmacist services such as medication review, counselling and treatment adherence clinics can improve clinical, health related quality of life and economic outcomes. To prove this hypothesis a step-wedge, cluster randomized controlled trial will be held in primary care centers of the public health system of Malaysia. Participants who have a high risk of cardiovascular risk factors currently seeking care in primary care will be recruited. Control group will receive usual care and the intervention arm will be seen by a pharmacist prior to their follow-up, with a comprehensive medication review, counselling and dietary advice consultations every month for three months. Participating pharmacist will be trained in cardiovascular prevention pharmacotherapy, interview skills, educational techniques, and develop personalized plan for every participant. The investigators plan to randomize up to 2100 participants who are currently receiving care in the primary care clinics in the district of Petaling by modifying the current workflow in primary care, whereby the investigators aim to get participants who are at high risk to undergo counselling as well as a medication review with proper pharmaceutical care delivered to them prior to seeking their medical doctor to receive care.

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients with diabetes
• Patients with chronic kidney disease (eGFR <60ml/min/1.73m2)
• Patients with established atherosclerotic vascular disease (via patient health records or selfreport) including cerebrovascular disease (prior stroke or transient ischemic attack), cardiovascular disease (myocardial infarction, acute coronary syndrome, stable angina, or revascularization), or peripheral arterial disease (symptomatic and/or ankle brachial index <0.9)
• Primary prevention patients with multiple risk factors and Framingham risk score >30%

Exclusion criteria

• Unwilling to participate/sign consent form
• Unwilling or unable to participate in regular follow-up visits
• Pregnancy
• Undergoing existing medication therapy adherence clinic conducted by the Pharmacy Unit

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Sequential Assignment

Masking: Double Blind

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0 participants in 2 patient groups

Enhanced pharmacist service

Experimental group

Description:

The advanced care group will be undergo a Comprehensive Annual Care Plan (CACP) or Standard Medication Management Assessment (SMMA) with the pharmacist

Treatment:

Other: Enhanced pharmacist service

Usual care

Active Comparator group

Description:

Patients in the usual care arm will receive their usual care which they will obtain care from their doctor,nurse and pharmacist where appropriate

Treatment:

Other: Usual care