title: A centralized cardiovascular risk service to improve guideline adherence in private primary care offices.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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 12 months and all subjects will have research visits at baseline and 12 months. 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 30 months to determine if the intervention effect is sustained after it is discontinued.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pharmacy Practice and Science, College of Pharmacy, United States; Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, United States. Electronic address: barry-carter@uiowa.edu.
authors.forename: Barry L
authors.initials: BL
authors.lastname: Carter
authors.affiliation: Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, United States.
authors.forename: Barcey T
authors.initials: BT
authors.lastname: Levy
authors.affiliation: Department of Pharmacy Practice and Science, College of Pharmacy, United States; Department of Epidemiology, College of Public Health, United States.
authors.forename: Brian
authors.initials: B
authors.lastname: Gryzlak
authors.affiliation: Department of Epidemiology, College of Public Health, United States.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Chrischilles
authors.affiliation: Iowa City Veterans Administration, United States; Department of Internal Medicine, Carver College of Medicine, United States; Department of Psychology, College of Liberal Arts, United States.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Vander Weg
authors.affiliation: Department of Internal Medicine, Carver College of Medicine, United States; Department of Psychology, College of Liberal Arts, United States.
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Christensen
authors.affiliation: Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, United States.
authors.forename: Paul A
authors.initials: PA
authors.lastname: James
authors.affiliation: Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, United States.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Moss
authors.affiliation: Department of Pharmacy Practice and Science, College of Pharmacy, United States.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Parker
authors.affiliation: Department of Pharmacy Practice and Science, College of Pharmacy, United States.
authors.forename: Tyler
authors.initials: T
authors.lastname: Gums
authors.affiliation: Department of Pharmacy Practice and Science, College of Pharmacy, United States.
authors.forename: Rachel J
authors.initials: RJ
authors.lastname: Finkelstein
authors.affiliation: Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, United States.
authors.forename: Yinghui
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Biostatistics, College of Public Health, The University of Iowa, United States.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Dawson
authors.affiliation: Department of Pharmacy Practice and Science, College of Pharmacy, United States.
authors.forename: Linnea A
authors.initials: LA
authors.lastname: Polgreen
mesh_terms: D000367:Age Factors; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D003299:Cooperative Behavior; D003376:Counseling; D003920:Diabetes Mellitus / Q000453:epidemiology; D004282:Documentation; D005260:Female; D019983:Guideline Adherence / Q000458:organization & administration*; D015438:Health Behavior; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D020407:Internet; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning; D010593:Pharmaceutical Services / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000458:organization & administration* / Q000592:standards; D011446:Prospective Studies; D017010:Reminder Systems; D012107:Research Design; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors
keywords: Cardiovascular disease; Clinical trial; Diabetes; Guideline adherence; Pharmacist management