title: Implementation of a pharmacist-led intervention to enhance statin prescribing for secondary prevention in primary care: a cluster randomized trial.
abstract: BACKGROUND
  Although statins have indisputably proven to reduce fatal and nonfatal events in patients with cardiovascular disease, many patients with established cardiovascular disease do not receive them. Research into the effective and efficient implementation of current guidelines on secondary prevention is therefore needed.
  
  
  METHODS
  A cluster randomized implementation trial was conducted between September 2006 and February 2008.
  
  
  METHODS
  Experimental pharmacists received an intensive implementation programme, whereas control pharmacists received an educational manual only. Pharmacists in both the groups were asked to identify eligible patients and to provide general practitioners (GPs) with lists of these patients. Physicians received instructions from the pharmacists to review the patients regarding a statin indication and to start a statin when they considered this as appropriate. Main outcome measure was the percentage of identified patients who received one or more statin prescriptions at 6 months follow-up.
  
  
  RESULTS
  Although twice as many patients were reviewed for a statin indication by a GP in the experimental group (19.7 vs. 10.8%, P = 0.023), an equally low number of patients in the experimental group and the control group received statins (5.8 vs. 5.3%, P = 0.104).
  
  
  CONCLUSIONS
  The intensive implementation programme had an impact on pharmacists and GPs, but did not result in more patients receiving statins.
authors: Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. c.vandesteeg-vangompel@iq.umcn.nl
authors: Caroline H P A
authors: CH
authors: van de Steeg-van Gompel
authors: Michel
authors: M
authors: Wensing
authors: Peter A G M
authors: PA
authors: De Smet
mesh_terms: D000368:Aged; D003157:Community Pharmacy Services; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D058006:General Practice; D019983:Guideline Adherence; D006284:Health Plan Implementation / Q000379:methods*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D057194:Intention to Treat Analysis; D008297:Male; D010595:Pharmacists; D011320:Primary Health Care; D055502:Secondary Prevention / Q000379:methods*
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors