title: The Cardiovascular Intervention Improvement Telemedicine Study (CITIES): rationale for a tailored behavioral and educational pharmacist-administered intervention for achieving cardiovascular disease risk reduction.
abstract: BACKGROUND
  Hypertension, hyperlipidemia, and diabetes are significant, but often preventable, contributors to cardiovascular disease (CVD) risk. Medication and behavioral nonadherence are significant barriers to successful hypertension, hyperlidemia, and diabetes management. Our objective was to describe the theoretical framework underlying a tailored behavioral and educational pharmacist-administered intervention for achieving CVD risk reduction.
  
  
  METHODS
  Adults with poorly controlled hypertension and/or hyperlipidemia were enrolled from three outpatient primary care clinics associated with the Durham Veterans Affairs Medical Center (Durham, NC). Participants were randomly assigned to receive a pharmacist-administered, tailored, 1-year telephone-based intervention or usual care. The goal of the study was to reduce the risk for CVD through a theory-driven intervention to increase medication adherence and improve health behaviors.
  
  
  RESULTS
  Enrollment began in November 2011 and is ongoing. The target sample size is 500 patients.
  
  
  CONCLUSIONS
  The Cardiovascular Intervention Improvement Telemedicine Study (CITIES) intervention has been designed with a strong theoretical underpinning. The theoretical foundation and intervention are designed to encourage patients with multiple comorbidities and poorly controlled CVD risk factors to engage in home-based monitoring and tailored telephone-based interventions. Evidence suggests that clinical pharmacist-administered telephone-based interventions may be efficiently integrated into primary care for patients with poorly controlled CVD risk factors.
authors.affiliation: 1 Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center , Durham, North Carolina.
authors.forename: Leah L
authors.initials: LL
authors.lastname: Zullig
authors.forename: S Dee
authors.initials: SD
authors.lastname: Melnyk
authors.forename: Karen M
authors.initials: KM
authors.lastname: Stechuchak
authors.forename: Felicia
authors.initials: F
authors.lastname: McCant
authors.forename: Susanne
authors.initials: S
authors.lastname: Danus
authors.forename: Eugene
authors.initials: E
authors.lastname: Oddone
authors.forename: Lori
authors.initials: L
authors.lastname: Bastian
authors.forename: Maren
authors.initials: M
authors.lastname: Olsen
authors.forename: David
authors.initials: D
authors.lastname: Edelman
authors.forename: Susan
authors.initials: S
authors.lastname: Rakley
authors.forename: Miriam
authors.initials: M
authors.lastname: Morey
authors.forename: Hayden B
authors.initials: HB
authors.lastname: Bosworth
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D048909:Diabetes Complications / Q000517:prevention & control; D003920:Diabetes Mellitus / Q000188:drug therapy; D005260:Female; D015438:Health Behavior; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000188:drug therapy; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D008297:Male; D055118:Medication Adherence; D010595:Pharmacists; D011320:Primary Health Care; D024382:Professional Role; D040242:Risk Reduction Behavior; D017216:Telemedicine / Q000379:methods*