Please select the eligibility criteria that correspond to the clinical trial below.
Title: The Alberta Vascular Risk Reduction Community Pharmacy Project: RxEACH
Brief Summary: Cardiovascular disease (disease of the heart and blood vessels) is one of the leading causes of death in Canada. It also carries a financial burden on the Canadian economy with a yearly cost close to $21 billion divided between loss of productivity and healthcare costs. The majority of cardiovascular disease cases (90%) are caused by factors that can be controlled and modified. These factors include high blood pressure, high cholesterol, diabetes (high blood sugar), tobacco smoking, unhealthy diet, obesity, physical inactivity and high alcohol consumption. Such factors are very common and not very well controlled and so individuals who have any of these factors would be at risk of having cardiovascular disease. As such controlling these factors will reduce the risk of having cardiovascular disease and improve the individuals' quality of life. Pharmacists frequently work with patients and their family doctor to provide cardiovascular care. Having a pharmacist involved in cardiovascular care may help patients with cardiovascular disease or at risk of having the disease because they are more accessible and may have more opportunities to educate people about cardiovascular medications. This might lead to better prevention and control of cardiovascular disease.

Purpose:

The research study will assess if a community pharmacy cardiovascular risk reduction intervention can help reduce cardiovascular risk.

Procedure:

If the individual has an elevated blood pressure, cholesterol, blood sugar, waist circumference or body weight or is physically inactive, have an unhealthy diet, a smoker or taking medications for any of the previously mentioned conditions, the pharmacist will assess the cardiovascular disease risk \[risk of having a cardiovascular event (e.g. heart attack or a stroke)\] using a computer program. If the individual is at high risk s/he will be asked to take part in the study.

If the individual agrees to take part in the study s/he will be randomly assigned to either the Usual Care Group or the Advanced Care Group. All participants have an equal chance of being assigned to either group. If assigned to the Usual Care Group, the individual will receive the care and services that would normally be provided by the pharmacist. At 3 months, the pharmacist will see the individual who will be offered the Advanced Care at that time.

If assigned to the to Advanced Care Group, the individual will be asked to meet with the pharmacist every 3-4 weeks over a 3 month period. During these meetings, the pharmacist will conduct an assessment that may include blood pressure, waist circumference, height and weight measurements and talk to the individual about their cardiovascular risk and medications. The individual and the pharmacist will come up with a plan for how to try to lower his/her cardiovascular risk. The pharmacist will discuss this plan with their family doctor. The individual will be asked to conduct some laboratory tests before the 3 months visit; these tests may include HbA1c (a blood test to measure blood sugar control over the last 3 months) and cholesterol to assess the effect of the intervention on cardiovascular risk.


Options:
A: Inclusion Criteria:

* Patients who have given their informed consent and expressed interest in participating in the study
* Asthmatic Patients

Exclusion Criteria:

* Patients with communication difficulties.
* Persons who obtain symbicort but not for their own use.
* Patients with other major diseases: Heart problems, COPD, EMPHYSEMA, lung cancer, AIDS.
* Patients with a respiratory infection.
* Patients with seasonal asthma.
* Pregnant women
* Patients who have previously participated in a health education study in asthma.
B: Inclusion Criteria:is African American and 18 years old or older; has active prescription for BP drug; obtains all BP drugs at the study pharmacy; is able to read and fill out short questionnaires; is able to come to pharmacy for 6 monthly pharmacy visits if needed; has screening BP between 140/90 mm Hg and 210/115 mm Hg.

Exclusion Criteria: history of organ transplant or kidney dialysis, symptoms of advanced congestive heart failure, memory impairment that interferes with daily functioning,terminal illness,pregnancy, alcohol or substance abuse problem,physician recommendation of exclusion for other condition that may require special care or limit participation in the study.
C: Inclusion Criteria:

* individuals who fill a (incident or prevalent) prescription for inhaled corticosteroids (either monotherapy or in combination inhaler with long-acting beta-agonists) who have been diagnosed by a doctor as having asthma
* possessing a cell-phone with ability to send/receive text messages
* residing in British Columbia (BC), Canada and planning to reside in BC for the next 12 months
* registered with the medical services plan (MSP, the provincial insure of medically-required services) in the past 12 months, and planning to remain registered for the next 12 months
* designated pharmacy being the main drugstore for patient
* not participating in another interventional study
* consent to participate in the study.

Exclusion Criteria:

* Unable to communicate in English
* Under 14 years of age
D: Inclusion Criteria:

* Adults (≥18 years of age) at high risk for cardiovascular events, including:

  * Patients with diabetes
  * Patients with chronic kidney disease \[eGFR \<60 ml/min/1.73m2 and/or (ACR \>= 30 mg/mmol or two consecutive ACR tests which are \>= 3 mg/mmol)\]
  * Patients with established atherosclerotic vascular disease including cerebrovascular disease (prior stroke or transient ischemic attack), cardiovascular disease (myocardial infarction, acute coronary syndrome, stable angina, or revascularization), or peripheral arterial disease (symptomatic and/or ankle brachial index \<0.9).
  * Primary prevention patients with multiple risk factors and Framingham risk score \>20%
  * In order to qualify for inclusion, all patients must have at least one uncontrolled risk factor (i.e., blood pressure, LDL-cholesterol, HbA1c, or current smoking)

Exclusion Criteria:

* Unwilling to participate/sign consent form
* Unwilling or unable to participate in regular follow-up visits
* Pregnancy

Answer: D