Dyslipidaemia Nutritional, Metabolic, Endocrine Dyslipidaemia
Conditions
Interventions
In the integrated primary care (IPC) intervention, family physicians will be responsible for the diagnosis and prescription of the statin treatment. Thereafter, the pharmacists will be responsible for
Sponsors
University of Montreal (Canada)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Aged greater than or equal to 18 years, either sex 2. Speak and read French or English 3. Are able to give informed consent and understand and follow study procedures 4. Agree to participate and sign the informed consent 5. According to the results of their last laboratory tests (performed in the previous three months), are candidate for initiating statin monotherapy or are currently on statin monotherapy at a non-optimal dose and are not adequately controlled according to one of the following criteria: 5.1. High risk (10-year coronary heart disease [CHD] risk greater than 20%): LDL-C greater than 2.5 mmol/l and total cholesterol (TC):high-density lipoprotein (HDL-C) ratio greater than 4 5.2. Moderate risk (10-year CHD risk between 11 - 19%): LDL-C greater than 3.5 mmol/l and TC:HDL-C ratio greater than 5 6. Agree to be followed by one of the participating family physicians and one of the pharmacists for the duration of the study (12 months) 7. IPC physician agrees to refer the patient to a participating pharmacist for dyslipidaemia-treatment follow-up 8. Physician agrees to delay the beginning or change of pharmacotherapy until the initial study visit 9. Patients are not patients of a particular pharmacy or report being patients of one of the participating pharmacies
Exclusion criteria
Exclusion criteria: 1. Patients already taking lipid-lowering medication and adequately controlled according to the most recent Canadian guidelines for the treatment of dyslipidaemia 2. Patients taking more than one lipid-lowering medication 3. Patients with acute cardiovascular disease (CVD) event (e.g. myocardial infarction, stroke and revascularisation) in the previous 6 months 4. Patients with a life-threatening disease or another health condition (severe mental problems, chronic alcoholism, renal insufficiency [creatinine clearance less than 60 ml/min], hepatic insufficiency [aspartate aminotransferase {AST}, alanine aminotransferase {ALT} greater than 3 x the upper normal limit] etc.) that, according to the referring physician, make them unlikely to complete the study 5. Patient with triglyceride greater than 5 mmol/l 6. Patient with LDL-C greater than 5 mmol/l 7. Patient with contraindication to statin medication (elevated transaminase levels [AST or ALT greater than 3 x the upper normal limit], history of myalgia with creatinine kinase [CK] greater than 10 x the upper normal limit) 8. Participating in another clinical trial
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Mean change in LDL-C from baseline to month 12 | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Achievement of the recommended target lipid levels, TC, HDL-C, TC/HDL-C, triglyceride, blood pressure, body mass index, fasting blood glucose, adherence and persistence to statin treatment, patient satisfaction, knowledge and decisional conflict, professionals' satisfaction 2. Application of the IPC intervention | — |
Countries
Canada
Outcome results
None listed