Improved Cardiovascular Risk Reduction to Enhance Rural Primary Care
- Conditions
- Diabetes MellitusCoronary Artery DiseaseHypertensionAtrial FibrillationStroke
- Interventions
- Other: PHCVRS InterventionOther: Personal Health Record
- Registration Number
- NCT01983813
- Lead Sponsor
- Korey Kennelty
- Brief Summary
The trial will examine whether a centralized Prevention Health \& Cardiovascular Risk Service (PHCVRS) run by clinical pharmacists at the University of Iowa can be implemented in primary care offices and whether it can improve the care delivered to patients at risk for developing cardiovascular disease.
- Detailed Description
The use of clinical pharmacists in primary care has improved the control of several chronic cardiovascular conditions. However, many private physician practices lack the resources to implement team-based care with pharmacists. The purpose of this study was to evaluate whether a centralized, remote, clinical pharmacy service could improve guideline adherence and secondary measures of cardiovascular risk in primary care offices in rural and small communities.
This study was a prospective trial in 12 family medicine offices cluster randomized to either the intervention or usual care. The intervention was delivered for 12 months, and subjects had research visits at baseline and 12 months. The primary outcome was adherence to guidelines, and secondary outcomes included changes in key cardiovascular risk factors and preventative health measures. We enrolled 302 subjects.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 302
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description PHCVRS intervention PHCVRS Intervention Each participant will receive communication with a clinical pharmacist for 12 months to decrease risk of developing cardiovascular disease. PHCVRS intervention Personal Health Record Each participant will receive communication with a clinical pharmacist for 12 months to decrease risk of developing cardiovascular disease. Usual care/Personal Health Record Personal Health Record Will receive usual medical care plus access to an online Personal Health Record, where the participant can document medications and diagnosed conditions.
- Primary Outcome Measures
Name Time Method Adherence of medical regimen/treatment to all of the Guideline Advantage criteria that apply. 12 months for each participant The primary outcome measure was adherence to the GA criteria as a surrogate for quality of care because each subject had varying gaps in guideline-concordant care, depending on their specific cardiovascular conditions and preventative care needs.
- Secondary Outcome Measures
Name Time Method Control of blood pressure, low density lipoprotein cholesterol and hemoglobin A1c. 12 months for each participant Secondary aims included control of BP, diabetes mellitus, and lipids for subjects whose conditions were not controlled at baseline.
Trial Locations
- Locations (12)
Akron Mercy Medical Clinic
🇺🇸Akron, Iowa, United States
Iowa Specialty Hospitals - Belmond Clinic
🇺🇸Belmond, Iowa, United States
Employee Health Clinic, Mercy Cedar Rapids
🇺🇸Cedar Rapids, Iowa, United States
Iowa Speciality Hospitals - Clarion Clinic
🇺🇸Clarion, Iowa, United States
Great River Medical Group
🇺🇸Davenport, Iowa, United States
Grinnell Regional Family Practice
🇺🇸Grinnell, Iowa, United States
Des Moines University Family Medicine Clinic
🇺🇸Des Moines, Iowa, United States
Knoxville Hospital Clinic
🇺🇸Knoxville, Iowa, United States
Newton Clinic, P.C.
🇺🇸Newton, Iowa, United States
UI Health Care-River Crossing
🇺🇸Riverside, Iowa, United States
Siouxland Community Health Center
🇺🇸Sioux City, Iowa, United States
Burlington Area Family Practice Center
🇺🇸West Burlington, Iowa, United States