title: A Cluster-Randomized Trial of a Centralized Clinical Pharmacy Cardiovascular Risk Service to Improve Guideline Adherence.
abstract: BACKGROUND
  Numerous studies have demonstrated the value of including pharmacists in team-based care to improve adherence to cardiovascular (CV) guidelines, medication adherence, and risk factor control. However, there is limited information on whether these models can be successfully implemented more widely in diverse settings and populations. The purpose of this study is to evaluate whether a centralized, web-based cardiovascular risk service (CVRS) managed by clinical pharmacists will improve guideline adherence in multiple primary care medical offices with diverse geographic and patient characteristics.
  
  
  METHODS
  This study is a prospective trial in 20 primary care offices stratified by the percent of under-represented minorities and then 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. The primary outcome is the difference in guideline adherence between groups. Data will also be abstracted from the medical record at 24 months to determine if the intervention effect is sustained after it is discontinued.
  
  
  CONCLUSIONS
  Patient enrollment will continue through 2016, with results expected in 2019. This study will provide information on whether a distant, centralized CVRS can be implemented in large numbers of medical offices, if it is effective in diverse populations, and if there is a long-term sustained effect.
authors.affiliation: Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, Iowa.|Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa.
authors.forename: Barry L
authors.initials: BL
authors.lastname: Carter
authors.affiliation: Department of Biostatistics, College of Public Health, Iowa City, Iowa.
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Coffey
authors.affiliation: Department of Epidemiology, College of Public Health, Iowa City, Iowa.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Chrischilles
authors.affiliation: Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, Iowa.
authors.forename: Gail
authors.initials: G
authors.lastname: Ardery
authors.affiliation: Department of Biostatistics, College of Public Health, Iowa City, Iowa.
authors.forename: Dixie
authors.initials: D
authors.lastname: Ecklund
authors.affiliation: Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, Iowa.|Department of Epidemiology, College of Public Health, Iowa City, Iowa.
authors.forename: Brian
authors.initials: B
authors.lastname: Gryzlak
authors.affiliation: Iowa City Veterans Administration, Iowa City, Iowa.|Department of Internal Medicine, Carver College of Medicine, Iowa City, Iowa.|Department of Psychology, College of Liberal Arts, The University of Iowa, Iowa City, Iowa.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Vander Weg
authors.affiliation: Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa.
authors.forename: Paul A
authors.initials: PA
authors.lastname: James
authors.affiliation: Department of Internal Medicine, Carver College of Medicine, Iowa City, Iowa.|Department of Psychology, College of Liberal Arts, The University of Iowa, Iowa City, Iowa.
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Christensen
authors.affiliation: Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, Iowa.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Parker
authors.affiliation: Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, Iowa.
authors.forename: Tyler
authors.initials: T
authors.lastname: Gums
authors.affiliation: Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, Iowa.
authors.forename: Rachel J
authors.initials: RJ
authors.lastname: Finkelstein
authors.affiliation: Department of Biostatistics, College of Public Health, Iowa City, Iowa.
authors.forename: Liz
authors.initials: L
authors.lastname: Uribe
authors.affiliation: Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, Iowa.
authors.forename: Linnea A
authors.initials: LA
authors.lastname: Polgreen
mesh_terms: D000553:Ambulatory Care; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D019983:Guideline Adherence; D006801:Humans; D010349:Patient Compliance; D010593:Pharmaceutical Services; D011446:Prospective Studies; D055502:Secondary Prevention
keywords: cardiovascular disease; clinical trial; diabetes; guideline adherence; pharmacist management