Studies
Pharmacist Intervention in Risk Reduction Study in High-Risk Cardiac Patients: The Effect of 2 Methods of Pharmacist Training
Author: Taylor J, Semchuk W, Deschamps M, Sulz L, Tsuyuki R, Duffy P, Wilson T
Intervention Type: Distribution of Educational Materials to Professionals, Educational Meetings for Professionals, Revision of Professional Roles
Disease State: Cardiovascular Disease
Research Objective
To assess the effect of conventional versus intensive training on pharmacist-suggested implementation of risk reduction efforts for cardiac patients in the community
Methods
Design: Randomized control trial that was 24 weeks in duration
Study sample: Pharmacists; Cardiac patients
Intervention:
All pharmacists were remunerated for each patient enrolled and for each patient that completed follow-up.
Group 1 – Intervention 1: Intensive training – Pharmacists received: 1) 6-hour workshop with presentation on patient counselling techniques, therapeutics, and interactive case-based sessions with standardized patients and E-support, 2) Study binder with handouts of the presentations made to them, study protocol, study forms, review articles, consensus statements, patient education tools, and letters of support from prominent local physicians
Group 2 – Intervention 2: Conventional training – Pharmacists received: 1) 2-hour evening lecture on cardiac patient management therapeutics. Received a study binder with handouts of the presentations made to them, study protocol, study forms, review articles, consensus statements, patient education tools, and letters of support from prominent local physicians
Medication Prescribing and Use Outcome(s)
Institution or enhancement of any risk reduction therapy
Other outcome(s)
Pharmacist satisfaction and self reported confidence with applicable practice skills
Key Results
- No significant difference recorded between groups in risk reduction therapy initiation or enhancement
- No significant differences between groups as to the number or type of recommendations made by pharmacists to doctors [Exception: the smoking cessation programs conventional group were twice as likely to recommend smoking cessation than those who were in the intensive group (18.6 vs. 7.6%), (p<0.05)]
- The acceptance rate of pharmacists’ recommendation by the physician for the intensive group (35.8%) was greater than the conventional group (23.8%), (p<0.05)
- No significant difference between groups for pharmacists satisfaction and self-reported confidence
Key Implementation Issues
- Study was underpowered as only 216/376 patients determined by sample size calculation were recruited
- Physician’s confidence level in the skill of a pharmacist may have contributed to lower rates of acceptance of recommendations.
- Study was not designed to assess the impact of professional reimbursement on pharmacist behaviour or cost of training.
- Pharmacists in the study were only 1% of those invited to participate. This suggests they might possess greater motivation and possibly necessary resources than most pharmacists in general.
- Difficult to ascertain was a true control would be in this study. The conventional group may not have represented ‘usual care’.
- Conventional group still ran other ‘heart health’ clinics. This may have skewed the results.
Citation(s)
Pharmacist Intervention in Risk Reduction Study in High-Risk Cardiac Patients: The Effect of 2 Methods of Pharmacist Training. Taylor, J., Semchuk, W., Deschamps, M., Sulz, L., Tsuyuki, R., Duffy, P., & Wilson, T. (2007). Can Pharm J, 140(2), 116-123.