Implementation of a Pharmacy-Intervention to Enhance Prescription and Use of Lipid-Lowering Drugs

Study Overview
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Brief Summary
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The purpose of this study is to determine the effectiveness of maximal support of community pharmacies to implement a pharmaceutical care model for improving underprescription and treatment persistence regarding lipid-lowering medication in patients with cardiovascular disease.

Detailed Description
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Cardiovascular disease is the main cause of death in large parts of the world. Next to life style changes, pharmaceutical treatment is a keystone in the treatment of cardiovascular disease. Despite the strong evidence for the effectiveness of lipid-lowering therapy, less than half of the people eligible are treated. With specific medication searches in the community pharmacy database, an easy tool for detecting patients who are undertreated is available. Based on this tool, a pharmaceutical care model for improving underprescription and treatment persistence regarding lipid-lowering medication in patients with cardiovascular disease was constructed. Moreover, it is not known yet how to implement this pharmaceutical care model in community pharmacies effectively. With multifaceted interventions the behaviour of health professionals can be changed. In this study the effectiveness of a maximal support strategy, including interactive educational meetings, reminders, audit and feedback, is compared to a minimal implementation strategy.

Official Title
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Implementation of a Pharmacy-Intervention to Enhance Prescription and Use of Lipid-Lowering Drugs. A Randomized Trial.

Conditions
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Cardiovascular Diseases

Intervention / Treatment
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* Other: intensive implementation programme
* Other: control


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: pharmacies: resident in the south of the Netherlands patients: with antiplatelet therapy and without lipid-lowering medication Exclusion Criteria:for patients: terminal disease severe mental disorder

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: experimental<br> | Other: intensive implementation programme<br>* educational manual; interactive educational meeting tailored to individual needs; reminders and feedback by 3 newsletters and at least 3 telephone calls.<br>|
| Active Comparator: control<br> | Other: control<br>* educational manual<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The percentage of selected (=undertreated) patients receiving at least one prescription for lipid-lowering medication. |  | six months after the general practitioner received the list with selected patients | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Differences in prescribing for age categories and co-medication. |  | six months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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quality of health care, prescriptions, drug, anticholesteremic agents, community pharmacy services