RxIALTA: 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

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 arthrit...

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Main Authors: Ross Tsuyuki, Carlo Marra, Yazid N Al Hamarneh, Robert Gniadecki, Stephanie Keeling, Andrea Morgan
Format: Article
Language:English
Published: BMJ Publishing Group 2021-03-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/3/e043612.full
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author Ross Tsuyuki
Carlo Marra
Yazid N Al Hamarneh
Robert Gniadecki
Stephanie Keeling
Andrea Morgan
author_facet Ross Tsuyuki
Carlo Marra
Yazid N Al Hamarneh
Robert Gniadecki
Stephanie Keeling
Andrea Morgan
author_sort Ross Tsuyuki
collection DOAJ
description 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. RxIALTA 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.
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spelling doaj-art-83027f7505e74c33a04afcc015814d8f2024-11-20T17:00:08ZengBMJ Publishing GroupBMJ Open2044-60552021-03-0111310.1136/bmjopen-2020-043612RxIALTA: 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 studyRoss Tsuyuki0Carlo Marra1Yazid N Al Hamarneh2Robert Gniadecki3Stephanie Keeling4Andrea Morgan5Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, CanadaSchool of Pharmacy, University of Otago Division of Health Sciences, Dunedin, New ZealandEPICORE Centre, University of Alberta, Edmonton, Alberta, CanadaMedicine, University of Alberta, Edmonton, Alberta, CanadaUniversity of Alberta, Edmonton, CanadaFoothills Medical Centre, Calgary, Alberta, CanadaObjective 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. RxIALTA 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.https://bmjopen.bmj.com/content/11/3/e043612.full
spellingShingle Ross Tsuyuki
Carlo Marra
Yazid N Al Hamarneh
Robert Gniadecki
Stephanie Keeling
Andrea Morgan
RxIALTA: 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
BMJ Open
title RxIALTA: 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 RxIALTA: 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 RxIALTA: 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 RxIALTA: 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 RxIALTA: 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 rxialta 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
url https://bmjopen.bmj.com/content/11/3/e043612.full
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