Yazid N Al Hamarneh1, Brenda R Hemmelgarn2, Imran Hassan3, Charlotte A Jones4, Ross T Tsuyuki3. 1. EPICORE Centre, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada. Electronic address: yazid.alhamarneh@ualberta.ca. 2. Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Interdisciplinary Chronic Disease Collaboration, Teaching Research and Wellness Building, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. 3. EPICORE Centre, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada. 4. Southern Medical Program, University of British Columbia, Kelowna, British Columbia, Canada.
Abstract
Cardiovascular disease (CVD) is the leading cause of death among patients with diabetes. Management and control of CV risk factors in those with diabetes are generally poor. Pharmacists are frontline primary healthcare providers who see patients with chronic diseases frequently. As such, they are in a prime position to systematically identify patients with diabetes, assess their CV risk and assist in their disease management and preventive measures. OBJECTIVE: to evaluate the effect of pharmacist case finding and intervention program on estimated CV risk in patients with diabetes. METHODS: Sub-group analysis of a randomized controlled trial (RxEACH). Patients were randomized to receive intervention or usual care for 3 months. Those who were randomized to the intervention group received a Medication Therapy Management consultation which included patient assessment, laboratory assessment, individualized CV risk assessment. Treatment regimen adjustment, as needed, in order to meet treatment targets. RESULTS:Estimated CV risk was reduced from 26.9 +/- 21% to 26.5 +/- 21.3% in the control group and from 25.8 +/- 19.4% to 20.1 +/- 17.2% in the intervention group over the 3-month follow up period (an absolute reduction of 5.38; 95% confidence interval (CI) 4.24 to 6.52; p <0.001). DISCUSSION AND CONCLUSION: Community pharmacy-based case finding and intervention program reduced the risk for major CV events by 21% when compared to usual practice. This represents a promising approach to help tackle the major public health problem of diabetes in Canada.
RCT Entities:
Cardiovascular disease (CVD) is the leading cause of death among patients with diabetes. Management and control of CV risk factors in those with diabetes are generally poor. Pharmacists are frontline primary healthcare providers who see patients with chronic diseases frequently. As such, they are in a prime position to systematically identify patients with diabetes, assess their CV risk and assist in their disease management and preventive measures. OBJECTIVE: to evaluate the effect of pharmacist case finding and intervention program on estimated CV risk in patients with diabetes. METHODS: Sub-group analysis of a randomized controlled trial (RxEACH). Patients were randomized to receive intervention or usual care for 3 months. Those who were randomized to the intervention group received a Medication Therapy Management consultation which included patient assessment, laboratory assessment, individualized CV risk assessment. Treatment regimen adjustment, as needed, in order to meet treatment targets. RESULTS: Estimated CV risk was reduced from 26.9 +/- 21% to 26.5 +/- 21.3% in the control group and from 25.8 +/- 19.4% to 20.1 +/- 17.2% in the intervention group over the 3-month follow up period (an absolute reduction of 5.38; 95% confidence interval (CI) 4.24 to 6.52; p <0.001). DISCUSSION AND CONCLUSION: Community pharmacy-based case finding and intervention program reduced the risk for major CV events by 21% when compared to usual practice. This represents a promising approach to help tackle the major public health problem of diabetes in Canada.
Authors: Liz Steed; Ratna Sohanpal; Adam Todd; Vichithranie W Madurasinghe; Carol Rivas; Elizabeth A Edwards; Carolyn D Summerbell; Stephanie Jc Taylor; R T Walton Journal: Cochrane Database Syst Rev Date: 2019-12-06
Authors: Katherine G Garlo; David W Bates; Diane L Seger; Julie M Fiskio; David M Charytan Journal: Medicine (Baltimore) Date: 2019-12 Impact factor: 1.889
Authors: R Varas-Doval; L Saéz-Benito; M A Gastelurrutia; S I Benrimoj; V Garcia-Cardenas; F Martinez-Martínez Journal: BMC Health Serv Res Date: 2021-02-17 Impact factor: 2.655
Authors: Aisling Croke; Frank Moriarty; Fiona Boland; Laura McCullagh; Karen Cardwell; Susan M Smith; Barbara Clyne Journal: BMJ Open Date: 2021-03-22 Impact factor: 2.692
Authors: Yazid N Al Hamarneh; Carlo Marra; Robert Gniadecki; Stephanie Keeling; Andrea Morgan; Ross Tsuyuki Journal: BMJ Open Date: 2021-03-24 Impact factor: 2.692
Authors: Frank C Brosius; David Cherney; Patrick O Gee; Raymond C Harris; Alan S Kliger; Katherine R Tuttle; Susan E Quaggin Journal: Clin J Am Soc Nephrol Date: 2021-06-08 Impact factor: 10.614