A centralized cardiovascular risk service to improve guideline adherence in private primary care offices

• Published in: Contemporary clinical trials Vol. 43; pp. 25 - 32
• Main Authors: Carter, Barry L., Levy, Barcey T., Gryzlak, Brian, Chrischilles, Elizabeth A., Vander Weg, Mark W., Christensen, Alan J., James, Paul A., Moss, Carol A., Parker, Christopher P., Gums, Tyler, Finkelstein, Rachel J., Xu, Yinghui, Dawson, Jeffrey D., Polgreen, Linnea A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2015
• Subjects: Age Factors; Aged; Cardiovascular; Cardiovascular disease; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - prevention & control; Clinical trial; Cooperative Behavior; Counseling; Diabetes; Diabetes Mellitus - epidemiology; Documentation; Female; Guideline adherence; Guideline Adherence - organization & administration; Health Behavior; Hematology, Oncology, and Palliative Medicine; Humans; Hypercholesterolemia - epidemiology; Hypertension - epidemiology; Internet; Life Style; Male; Middle Aged; Patient Care Planning; Pharmaceutical Services - organization & administration; Pharmacist management; Practice Guidelines as Topic; Primary Health Care - organization & administration; Primary Health Care - standards; Prospective Studies; Reminder Systems; Research Design; Risk Factors; Sex Factors; Socioeconomic Factors; Guideline adherence; Cardiovascular disease; Clinical trial; Diabetes; Pharmacist management
• ISSN: 1551-7144; 1559-2030; 1559-2030
• DOI: 10.1016/j.cct.2015.04.014

Many large health systems now employ clinical pharmacists in team-based care to assist patients and physicians with management of cardiovascular (CV) diseases. However, small private offices often lack the resources to hire a clinical pharmacist for their office. The purpose of this study is to evaluate whether a centralized, web-based CV risk service (CVRS) managed by clinical pharmacists will improve guideline adherence in primary care medical offices in rural and small communities. This study is a cluster randomized prospective trial in 12 primary care offices. Medical offices were randomized to either the CVRS intervention or usual care. The intervention will last for 12months and all subjects will have research visits at baseline and 12months. Primary outcomes will include adherence to treatment guidelines and control of key CV risk factors. Data will also be abstracted from the medical record at 30months to determine if the intervention effect is sustained after it is discontinued. This study will enroll subjects through 2015 and results will be available in 2018. This study will provide information on whether a distant, centralized CV risk service can improve guideline adherence in medical offices that lack the resources to employ clinical pharmacists.