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R(x)IALTA: evaluating the effect of a pharmacist-led intervention on CV risk in patients with chronic inflammatory diseases in a community pharmacy setting: a prospective pre–post intervention study
Patients with inflammatory conditions are at high risk for cardiovascular (CV) disease. Despite such elevated risk, their CV risk factors are suboptimally managed. OBJECTIVE: To evaluate the effect of a pharmacist-led intervention on CV risk in patients with inflammatory conditions. METHODS: DESIGN:...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7993291/ https://www.ncbi.nlm.nih.gov/pubmed/33762234 http://dx.doi.org/10.1136/bmjopen-2020-043612 |
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author | Al Hamarneh, Yazid N Marra, Carlo Gniadecki, Robert Keeling, Stephanie Morgan, Andrea Tsuyuki, Ross |
author_facet | Al Hamarneh, Yazid N Marra, Carlo Gniadecki, Robert Keeling, Stephanie Morgan, Andrea Tsuyuki, Ross |
author_sort | Al Hamarneh, Yazid N |
collection | PubMed |
description | Patients with inflammatory conditions are at high risk for cardiovascular (CV) disease. Despite such elevated risk, their CV risk factors are suboptimally managed. OBJECTIVE: To evaluate the effect of a pharmacist-led intervention on CV risk in patients with inflammatory conditions. METHODS: DESIGN: Prospective pre–postintervention. SETTING: 17 community pharmacies across Alberta. POPULATION: Adults with inflammatory conditions (rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, gout, systemic lupus erythematosus, psoriasis vulgaris) who had at least one uncontrolled risk factor (A1C, blood pressure, LDL-cholesterol or current tobacco users). INTERVENTION: All patients enrolled in the study received: physical and laboratory assessment, individualised CV risk assessment and education regarding this risk, treatment recommendations, prescription adaptation and prescribing where necessary to meet treatment targets, regular communication with the patient’s treating physician(s) and regular follow-up with all patients every month for 6 months. OUTCOMES: Primary: change in estimated CV risk (risk of a major CV event in the next 10 years) after 6 months. Secondary: change in individual risk factors (blood pressure, LDL-cholesterol, A1C and tobacco cessation) over a 6-month period. RESULTS: We enrolled 99 patients. The median age was 66.41 years (IQR 57.64–72.79), More than half of them (61%) were female and more than three-quarters (86%) were Caucasians. After adjusting for age, sex and ethnicity and centre effect, there was a reduction of 24.5% in CV risk (p<0.001); including a reduction of 0.3 mmol/L in LDL-c (p<0.001), 10.7 mm Hg in systolic blood pressure (p<0.001), 1.25% in A1C (p<0.001). There was a non-significant trend towards tobacco cessation. CONCLUSION: This is the first study on CV risk reduction in patients with inflammatory conditions in a community pharmacy setting. R(x)IALTA provides evidence for the benefit of pharmacist care on global cardiovascular risk reduction as well as the individual cardiovascular risk factors in patients with inflammatory conditions. TRIAL REGISTRATION NUMBER: NCT03152396. |
format | Online Article Text |
id | pubmed-7993291 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-79932912021-04-19 R(x)IALTA: evaluating the effect of a pharmacist-led intervention on CV risk in patients with chronic inflammatory diseases in a community pharmacy setting: a prospective pre–post intervention study Al Hamarneh, Yazid N Marra, Carlo Gniadecki, Robert Keeling, Stephanie Morgan, Andrea Tsuyuki, Ross BMJ Open Rheumatology Patients with inflammatory conditions are at high risk for cardiovascular (CV) disease. Despite such elevated risk, their CV risk factors are suboptimally managed. OBJECTIVE: To evaluate the effect of a pharmacist-led intervention on CV risk in patients with inflammatory conditions. METHODS: DESIGN: Prospective pre–postintervention. SETTING: 17 community pharmacies across Alberta. POPULATION: Adults with inflammatory conditions (rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, gout, systemic lupus erythematosus, psoriasis vulgaris) who had at least one uncontrolled risk factor (A1C, blood pressure, LDL-cholesterol or current tobacco users). INTERVENTION: All patients enrolled in the study received: physical and laboratory assessment, individualised CV risk assessment and education regarding this risk, treatment recommendations, prescription adaptation and prescribing where necessary to meet treatment targets, regular communication with the patient’s treating physician(s) and regular follow-up with all patients every month for 6 months. OUTCOMES: Primary: change in estimated CV risk (risk of a major CV event in the next 10 years) after 6 months. Secondary: change in individual risk factors (blood pressure, LDL-cholesterol, A1C and tobacco cessation) over a 6-month period. RESULTS: We enrolled 99 patients. The median age was 66.41 years (IQR 57.64–72.79), More than half of them (61%) were female and more than three-quarters (86%) were Caucasians. After adjusting for age, sex and ethnicity and centre effect, there was a reduction of 24.5% in CV risk (p<0.001); including a reduction of 0.3 mmol/L in LDL-c (p<0.001), 10.7 mm Hg in systolic blood pressure (p<0.001), 1.25% in A1C (p<0.001). There was a non-significant trend towards tobacco cessation. CONCLUSION: This is the first study on CV risk reduction in patients with inflammatory conditions in a community pharmacy setting. R(x)IALTA provides evidence for the benefit of pharmacist care on global cardiovascular risk reduction as well as the individual cardiovascular risk factors in patients with inflammatory conditions. TRIAL REGISTRATION NUMBER: NCT03152396. BMJ Publishing Group 2021-03-24 /pmc/articles/PMC7993291/ /pubmed/33762234 http://dx.doi.org/10.1136/bmjopen-2020-043612 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Rheumatology Al Hamarneh, Yazid N Marra, Carlo Gniadecki, Robert Keeling, Stephanie Morgan, Andrea Tsuyuki, Ross R(x)IALTA: evaluating the effect of a pharmacist-led intervention on CV risk in patients with chronic inflammatory diseases in a community pharmacy setting: a prospective pre–post intervention study |
title | R(x)IALTA: evaluating the effect of a pharmacist-led intervention on CV risk in patients with chronic inflammatory diseases in a community pharmacy setting: a prospective pre–post intervention study |
title_full | R(x)IALTA: evaluating the effect of a pharmacist-led intervention on CV risk in patients with chronic inflammatory diseases in a community pharmacy setting: a prospective pre–post intervention study |
title_fullStr | R(x)IALTA: evaluating the effect of a pharmacist-led intervention on CV risk in patients with chronic inflammatory diseases in a community pharmacy setting: a prospective pre–post intervention study |
title_full_unstemmed | R(x)IALTA: evaluating the effect of a pharmacist-led intervention on CV risk in patients with chronic inflammatory diseases in a community pharmacy setting: a prospective pre–post intervention study |
title_short | R(x)IALTA: evaluating the effect of a pharmacist-led intervention on CV risk in patients with chronic inflammatory diseases in a community pharmacy setting: a prospective pre–post intervention study |
title_sort | r(x)ialta: evaluating the effect of a pharmacist-led intervention on cv risk in patients with chronic inflammatory diseases in a community pharmacy setting: a prospective pre–post intervention study |
topic | Rheumatology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7993291/ https://www.ncbi.nlm.nih.gov/pubmed/33762234 http://dx.doi.org/10.1136/bmjopen-2020-043612 |
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