Open Access Study protocol

Engaging community pharmacists in the primary prevention of cardiovascular disease: protocol for the Pharmacist Assessment of Adherence, Risk and Treatment in Cardiovascular Disease (PAART CVD) pilot study

Kevin P Mc Namara12*, Johnson George1, Sharleen L O'Reilly3, Shane L Jackson4, Gregory M Peterson4, Helen Howarth4, Michael J Bailey5, Gregory Duncan16, Peta Trinder1, Elizabeth Morabito1, Jill Finch4, Stephen Bunker2, Edward Janus27, Jon Emery8 and James A Dunbar2

Author Affiliations

1 Centre for Medicine Use and Safety, Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, VIC 3052, Australia

2 Greater Green Triangle University Department of Rural Health, Flinders and Deakin Universities, Deakin University, Princes Hwy, Warrnambool, VIC 3280, Australia

3 Centre for Physical Activity and Nutrition Research, Faculty of Health Medicine Nursing & Behavioural Sciences, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia

4 Unit for Medication Outcomes Research and Education, School of Pharmacy, University of Tasmania, Churchill Avenue, Sandy Bay, TAS 7005, Australia

5 Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Commercial Road, VIC 3004, Australia

6 Peter James Centre, Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Mahoney's Road, Burwood East, Victoria 3151 Australia

7 Department of Medicine, University of Melbourne, Western Hospital, Gordon Street, Footscray VIC 3011

8 School of Primary, Aboriginal and Rural Health Care. The University of Western Australia (M501), 35 Stirling Highway, Crawley, Western Australia 6009, Australia

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BMC Health Services Research 2010, 10:264  doi:10.1186/1472-6963-10-264

Published: 7 September 2010

Abstract

Background

Cardiovascular disease (CVD) is the leading cause of death globally. Community pharmacist intervention studies have demonstrated clinical effectiveness for improving several leading individual CVD risk factors. Primary prevention strategies increasingly emphasise the need for consideration of overall cardiovascular risk and concurrent management of multiple risk factors. It is therefore important to demonstrate the feasibility of multiple risk factor management by community pharmacists to ensure continued currency of their role.

Methods/Design

This study will be a longitudinal pre- and post-test pilot study with a single cohort of up to 100 patients in ten pharmacies. Patients aged 50-74 years with no history of heart disease or diabetes, and taking antihypertensive or lipid-lowering medicines, will be approached for participation. Assessment of cardiovascular risk, medicines use and health behaviours will be undertaken by a research assistant at baseline and following the intervention (6 months). Validated interview scales will be used where available. Baseline data will be used by accredited medicines management pharmacists to generate a report for the treating community pharmacist. This report will highlight individual patients' overall CVD risk and individual risk factors, as well as identifying modifiable health behaviours for risk improvement and suggesting treatment and behavioural goals. The treating community pharmacist will use this information to finalise and implement a treatment plan in conjunction with the patient and their doctor. Community pharmacists will facilitate patient improvements in lifestyle, medicines adherence, and medicines management over the course of five counselling sessions with monthly intervals. The primary outcome will be the change to average overall cardiovascular risk, assessed using the Framingham risk equation.

Discussion

This study will assess the feasibility of implementing holistic primary CVD prevention programs into community pharmacy, one of the most accessible health services in most developed countries.

Trial registration

Australia and New Zealand Clinical Trial Registry Number: ACTRN12609000677202