Please select the eligibility criteria that correspond to the clinical trial below.
Title: Reducing Total Cardiovascular Risk in an Urban Community
Brief Summary: PLEASE NOTE: THIS STUDY IS ONLY ENROLLING PATIENTS CURRENTLY BEING TREATED AT BELAIR-EDISON FAMILY HEALTH CENTER.

The purpose of this study is to compare the clinical effectiveness and cost effectiveness of two cardiovascular risk reduction programs - a comprehensive intensive (Cl) intervention with a less intensive (LI) intervention - in African American, and white low-income patients with known excessive cardiovascular disease risk.


Options:
A: Inclusion Criteria:

* Currently receiving medical care at Johns Hopkins University
* African American or Caucasian and have diagnosed CVD, defined as a prior myocardial infarction, revascularization procedure for coronary disease, ischemic heart disease, stroke, or have diagnosed type 2 diabetes and not receiving any therapy
* Have either no LDL-C in their medical record during the 12 months prior to study entry or have an LDL greater than or equal to 100 mg/dl on or off lipid lowering pharmacotherapy
* Have either no blood pressure recorded in their medical record during the 12 months prior to study entry or a BP greater than 140/90 mmHg or greater than 130/80 mmHg if the participant is diabetic or has renal insufficiency
* If the participant is diabetic he or she has to either have no HbA1c recorded during the 12 months prior to study entry or HbA1c of 7 percent or greater

Exclusion criteria:

* A serious life-threatening noncardiac comorbidity with a life expectancy of less than 5 years
* A serious physician-recorded psychiatric morbidity that would interfere with the study
* Sufficient neurological impairment that would interfere with the study
B: Inclusion Criteria:

* Receiving primary health care from Elmwood Family Physicians; and
* Medicare beneficiary; and
* Currently prescribed at least 7 medications, or prescriber feels patient would benefit from enhanced medication therapy management, or actual or suspected medication-related problem

Exclusion Criteria:

* Not willing to participate in the study and sign informed consent; or
* Non-English speaking or designated surrogate as translator not available
C: Inclusion Criteria:

* Admitted to a participating study hospital
* Diagnosis of acute coronary syndromes or heart failure

Exclusion Criteria:

* Too ill to participate
* Corrected visual acuity worse than 20/200
* Severe hearing impairment
* Patient is not being discharged to their home
* No regular telephone number
* Not fluent in English or Spanish
* Unintelligible speech
* In police custody
* Caregiver manages all medications
* Delirium or severe dementia
* Psychotic illness
* Already participating in a conflicting study
D: Inclusion Criteria:

* Be at least 65 years old at enrollment
* Primarily uses English language for written and oral communication
* Have three or more comorbid conditions associated with increased healthcare utilization (Diabetes Mellitus, Congestive Heart Failure, Asthma, Hypertension, Dyslipidemia, COPD, Coronary Artery Disease, Chronic Renal Failure, Arthritis, Depression, Dementia, Chronic Pain, Conditions requiring anticoagulation with warfarin)
* Have visited a physician at one or more of the clinics on a regular basis (defined as two or more clinic visits over one year prior to the study start) for these conditions
* Have received 6 or more different chronic prescription medications over the six months prior to the enrollment period
* Have a telephone line and agree to maintain it for at least six months
* Have one of the following situations placing him/her at risk for a DRP (Any ER visit in past 30 days or Urgent Care visit in past 30 days leading to a change in medication or change in medication dose; New physician visit in past 30 days; Hospitalization in past 30 days; Invasive procedure (a procedure requiring substantive changes to medication taking practices or which requires informed consent) in past 30 days; Change in medication in past 30 days; Three or more providers seen in the past year

Exclusion Criteria:

* Terminal condition, where life expectancy is less than 6 months
* Patients already enrolled in an MTM program where medication reconciliation and/or assessment of DRPs has occurred in the previous 12 months

Answer: A