An integrated general practice and pharmacy-based intervention to promote the use of appropriate preventive medications among individuals at high cardiovascular disease risk: Protocol for a cluster randomized controlled trial
Background: Cardiovascular diseases (CVD) are responsible for significant morbidity, premature mortality, and economic burden. Despite established evidence that supports the use of preventive medications among patients at high CVD risk, treatment gaps remain. Building on prior evidence and a theoret...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Journal Article |
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BioMed Central Ltd.
2016
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| Online Access: | http://hdl.handle.net/20.500.11937/44297 |
| _version_ | 1848756960338378752 |
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| author | Hayek, A. Joshi, R. Usherwood, T. Webster, R. Kaur, B. Saini, B. Armour, C. Krass, I. Laba, T. Reid, Christopher Shiel, L. Hespe, C. Hersch, F. Jan, S. Lo, S. Peiris, D. Rodgers, A. Patel, A. |
| author_facet | Hayek, A. Joshi, R. Usherwood, T. Webster, R. Kaur, B. Saini, B. Armour, C. Krass, I. Laba, T. Reid, Christopher Shiel, L. Hespe, C. Hersch, F. Jan, S. Lo, S. Peiris, D. Rodgers, A. Patel, A. |
| author_sort | Hayek, A. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Background: Cardiovascular diseases (CVD) are responsible for significant morbidity, premature mortality, and economic burden. Despite established evidence that supports the use of preventive medications among patients at high CVD risk, treatment gaps remain. Building on prior evidence and a theoretical framework, a complex intervention has been designed to address these gaps among high-risk, under-treated patients in the Australian primary care setting. This intervention comprises a general practice quality improvement tool incorporating clinical decision support and audit/feedback capabilities; availability of a range of CVD polypills (fixed-dose combinations of two blood pressure lowering agents, a statin ± aspirin) for prescription when appropriate; and access to a pharmacy-based program to support long-term medication adherence and lifestyle modification. Methods: Following a systematic development process, the intervention will be evaluated in a pragmatic cluster randomized controlled trial including 70 general practices for a median period of 18months. The 35 general practices in the intervention group will work with a nominated partner pharmacy, whereas those in the control group will provide usual care without access to the intervention tools. The primary outcome is the proportion of patients at high CVD risk who were inadequately treated at baseline who achieve target blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) levels at the study end. The outcomes will be analyzed using data from electronic medical records, utilizing a validated extraction tool. Detailed process and economic evaluations will also be performed. Discussion: The study intends to establish evidence about an intervention that combines technological innovation with team collaboration between patients, pharmacists, and general practitioners (GPs) for CVD prevention. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12616000233426 |
| first_indexed | 2025-11-14T09:20:30Z |
| format | Journal Article |
| id | curtin-20.500.11937-44297 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T09:20:30Z |
| publishDate | 2016 |
| publisher | BioMed Central Ltd. |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-442972017-09-13T14:29:23Z An integrated general practice and pharmacy-based intervention to promote the use of appropriate preventive medications among individuals at high cardiovascular disease risk: Protocol for a cluster randomized controlled trial Hayek, A. Joshi, R. Usherwood, T. Webster, R. Kaur, B. Saini, B. Armour, C. Krass, I. Laba, T. Reid, Christopher Shiel, L. Hespe, C. Hersch, F. Jan, S. Lo, S. Peiris, D. Rodgers, A. Patel, A. Background: Cardiovascular diseases (CVD) are responsible for significant morbidity, premature mortality, and economic burden. Despite established evidence that supports the use of preventive medications among patients at high CVD risk, treatment gaps remain. Building on prior evidence and a theoretical framework, a complex intervention has been designed to address these gaps among high-risk, under-treated patients in the Australian primary care setting. This intervention comprises a general practice quality improvement tool incorporating clinical decision support and audit/feedback capabilities; availability of a range of CVD polypills (fixed-dose combinations of two blood pressure lowering agents, a statin ± aspirin) for prescription when appropriate; and access to a pharmacy-based program to support long-term medication adherence and lifestyle modification. Methods: Following a systematic development process, the intervention will be evaluated in a pragmatic cluster randomized controlled trial including 70 general practices for a median period of 18months. The 35 general practices in the intervention group will work with a nominated partner pharmacy, whereas those in the control group will provide usual care without access to the intervention tools. The primary outcome is the proportion of patients at high CVD risk who were inadequately treated at baseline who achieve target blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) levels at the study end. The outcomes will be analyzed using data from electronic medical records, utilizing a validated extraction tool. Detailed process and economic evaluations will also be performed. Discussion: The study intends to establish evidence about an intervention that combines technological innovation with team collaboration between patients, pharmacists, and general practitioners (GPs) for CVD prevention. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12616000233426 2016 Journal Article http://hdl.handle.net/20.500.11937/44297 10.1186/s13012-016-0488-1 BioMed Central Ltd. fulltext |
| spellingShingle | Hayek, A. Joshi, R. Usherwood, T. Webster, R. Kaur, B. Saini, B. Armour, C. Krass, I. Laba, T. Reid, Christopher Shiel, L. Hespe, C. Hersch, F. Jan, S. Lo, S. Peiris, D. Rodgers, A. Patel, A. An integrated general practice and pharmacy-based intervention to promote the use of appropriate preventive medications among individuals at high cardiovascular disease risk: Protocol for a cluster randomized controlled trial |
| title | An integrated general practice and pharmacy-based intervention to promote the use of appropriate preventive medications among individuals at high cardiovascular disease risk: Protocol for a cluster randomized controlled trial |
| title_full | An integrated general practice and pharmacy-based intervention to promote the use of appropriate preventive medications among individuals at high cardiovascular disease risk: Protocol for a cluster randomized controlled trial |
| title_fullStr | An integrated general practice and pharmacy-based intervention to promote the use of appropriate preventive medications among individuals at high cardiovascular disease risk: Protocol for a cluster randomized controlled trial |
| title_full_unstemmed | An integrated general practice and pharmacy-based intervention to promote the use of appropriate preventive medications among individuals at high cardiovascular disease risk: Protocol for a cluster randomized controlled trial |
| title_short | An integrated general practice and pharmacy-based intervention to promote the use of appropriate preventive medications among individuals at high cardiovascular disease risk: Protocol for a cluster randomized controlled trial |
| title_sort | integrated general practice and pharmacy-based intervention to promote the use of appropriate preventive medications among individuals at high cardiovascular disease risk: protocol for a cluster randomized controlled trial |
| url | http://hdl.handle.net/20.500.11937/44297 |