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No enrollment due to difficulty in recruitment of study sites
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| Name | Class |
|---|---|
| Klinik Kesihatan Puchong | UNKNOWN |
| Klinik Kesihatan Kelana Jaya | UNKNOWN |
| Klinik Kesihatan Shah Alam Seksyen 7 | UNKNOWN |
| Klinik Kesihatan Shah Alam Seksyen 9 |
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Pharmacist services such as medication review, counselling and treatment adherence clinics can improve clinical, health related quality of life and economic outcomes. To prove this hypothesis a step-wedge, cluster randomized controlled trial will be held in primary care centers of the public health system of Malaysia. Participants who have a high risk of cardiovascular risk factors currently seeking care in primary care will be recruited. Control group will receive usual care and the intervention arm will be seen by a pharmacist prior to their follow-up, with a comprehensive medication review, counselling and dietary advice consultations every month for three months. Participating pharmacist will be trained in cardiovascular prevention pharmacotherapy, interview skills, educational techniques, and develop personalized plan for every participant. The investigators plan to randomize up to 2100 participants who are currently receiving care in the primary care clinics in the district of Petaling by modifying the current workflow in primary care, whereby the investigators aim to get participants who are at high risk to undergo counselling as well as a medication review with proper pharmaceutical care delivered to them prior to seeking their medical doctor to receive care.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Enhanced pharmacist service | Experimental | The advanced care group will be undergo a Comprehensive Annual Care Plan (CACP) or Standard Medication Management Assessment (SMMA) with the pharmacist |
|
| Usual care | Active Comparator | Patients in the usual care arm will receive their usual care which they will obtain care from their doctor,nurse and pharmacist where appropriate |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Enhanced pharmacist service | Other | Calculation of cardiovascular risk by an online tool for discussion on the CVD risk. Pharmacist will also provide ducation on cardiovascular risk factors and healthy lifestyle. Any prescription adaptation(s), and/or recommendations where necessary to meet lipid, blood pressure and glycemic control targets and smoking cessation will be initiated |
| Measure | Description | Time Frame |
|---|---|---|
| Change in cardiovascular risk scores | The difference from baseline to 3 months in the estimated cardiovascular risk between advanced care and usual care groups assessed using the Framingham scale | 3 months |
| Measure | Description | Time Frame |
|---|---|---|
| Change in cardiovascular risk scores | The difference from baseline to 6 months in the estimated cardiovascular risk between advanced care and usual care groups assessed using the Framingham scale | 6 months |
| Change in cardiovascular risk scores |
| Measure | Description | Time Frame |
|---|---|---|
| Efficiency of screening | Number of high risk patients screened for cardiovascular risk | 3 months |
| Change in participant quality of life | Change in quality of life assessed using EuroQoL-5D from baseline to end of intervention (range 0-1) |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Shaun Lee | Monash University Malaysia | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Shaun Lee | Subang Jaya | Selangor | 47500 | Malaysia |
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| ID | Term |
|---|---|
| D002318 | Cardiovascular Diseases |
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| UNKNOWN |
| Klinik Kesihatan Taman Medan | UNKNOWN |
| Klinik Kesihatan Seri Kembangan | UNKNOWN |
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| Usual care | Other | Participants in the arm will receive their care from their respective nurse, doctor or pharmacists as per usual clinic practice |
|
The difference from baseline to 12 months in the estimated cardiovascular risk between advanced care and usual care groups assessed using the Framingham scale
| 12 months |
| Change in cardiovascular risk scores | The difference from baseline to 24 months in the estimated cardiovascular risk between advanced care and usual care groups assessed using the Framingham scale | 24 months |
| Achievement of recommended cholesterol, blood pressure and glycemic control targets | Number of individual achieving target cholesterol, blood pressure and glycemic control target | 3 months |
| Proportion of patients receiving appropriate medication | Number of patients receiving appropriate BP, cholesterol and diabetes medication | 3 months |
| 3 months |