Engaging community pharmacists in the primary prevention of cardiovascular disease: protocol for the Pharmacist Assessment of Adherence, Risk and Treatment in Cardiovascular Disease (PAART CVD) pilot study.
BACKGROUND
Cardiovascular disease (CVD) is the leading cause of death globally. Community pharmacist intervention studies have demonstrated clinical effectiveness for improving several leading individual CVD risk factors. Primary prevention strategies increasingly emphasise the need for consideration of overall cardiovascular risk and concurrent management of multiple risk factors. It is therefore important to demonstrate the feasibility of multiple risk factor management by community pharmacists to ensure continued currency of their role.


METHODS
This study will be a longitudinal pre- and post-test pilot study with a single cohort of up to 100 patients in ten pharmacies. Patients aged 50-74 years with no history of heart disease or diabetes, and taking antihypertensive or lipid-lowering medicines, will be approached for participation. Assessment of cardiovascular risk, medicines use and health behaviours will be undertaken by a research assistant at baseline and following the intervention (6 months). Validated interview scales will be used where available. Baseline data will be used by accredited medicines management pharmacists to generate a report for the treating community pharmacist. This report will highlight individual patients' overall CVD risk and individual risk factors, as well as identifying modifiable health behaviours for risk improvement and suggesting treatment and behavioural goals. The treating community pharmacist will use this information to finalise and implement a treatment plan in conjunction with the patient and their doctor. Community pharmacists will facilitate patient improvements in lifestyle, medicines adherence, and medicines management over the course of five counselling sessions with monthly intervals. The primary outcome will be the change to average overall cardiovascular risk, assessed using the Framingham risk equation.


CONCLUSIONS
This study will assess the feasibility of implementing holistic primary CVD prevention programs into community pharmacy, one of the most accessible health services in most developed countries.


BACKGROUND
Australia and New Zealand Clinical Trial Registry Number: ACTRN12609000677202.
Mc Namara
Kevin P
KP
Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Centre for Medicine Use and Safety, 381 Royal Parade, Parkville, VIC 3052, Australia. kevin.p.mcnamara@monash.edu
George
Johnson
J
O'Reilly
Sharleen L
SL
Jackson
Shane L
SL
Peterson
Gregory M
GM
Howarth
Helen
H
Bailey
Michael J
MJ
Duncan
Gregory
G
Trinder
Peta
P
Morabito
Elizabeth
E
Finch
Jill
J
Bunker
Stephen
S
Janus
Edward
E
Emery
Jon
J
Dunbar
James A
JA
D000368:Aged; D001315:Australia; D002317:Cardiovascular Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000401:mortality / Q000517:prevention & control*; D003157:Community Pharmacy Services / Q000458:organization & administration*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D017408:Guidelines as Topic; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010595:Pharmacists / Q000458:organization & administration*; D010865:Pilot Projects; D011322:Primary Prevention / Q000458:organization & administration*; D015397:Program Evaluation; D018570:Risk Assessment; D012424:Rural Population; D016896:Treatment Outcome; D014505:Urban Population
D002317:Cardiovascular Agents
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