Cardiovascular Diseases in Old Age
Conditions
Keywords
medication managements services, pharmaceutical care, primary care, elderly, control group, cardiovascular disease
Brief summary
Patients with established cardiovascular disease (CVD) often have multiple medications that increase the risk of prevalence of drug therapy problems (DTP), subsequently leading to unfavourable clinical and health outcomes. By providing Comprehensive Medication Management (CMM) services to patients within a healthcare system, pharmacists assess patients' medication-related needs, identify and prevent DTP, develop individualized care plan for each individual patient and evaluate and monitor outcomes. Thus, the CMM services delivered at the primary care level in collaboration with general practitioners and other healthcare providers could address this problem and by optimizing therapy improve patients' clinical outcomes and quality of life. Studies have shown that patients with chronic diseases have the greatest benefit from the CMM services. The aim of this study is to evaluate the impact of CMM services on clinical and humanistic outcomes in patients with established CVD. The study will employ prospective, longitudinal, pre- and postintervention study with a 1-year patient follow-up.
Interventions
OTHERComprehensive Medication Management services
Comprehensive Medication Management services (CMM services) is an evidence-based and patient-centred service which involves an assessment of patient's medications to determine that each medication is appropriate, effective for the medical condition being treated, safe for the patient in the presence of other medications and co-morbidities, and that the patient is able and willing to take the medications as intended. As all patient care providers need a structured, rational thought process for sound clinical decision retrieval, the Pharmacotherapy Workup was developed and adopted as a systematic problem-solving process. This process represents the cognitive work taking place in the mind of the practitioner, and is used to identify, resolve, and prevent drug therapy problems (DTP), establish therapy goals, select interventions and evaluate outcomes.
Sponsors
Health Centre Zagreb - Centre (Dom zdravlja Zagreb - Centar)
University of Zagreb
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
65 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Hypertension * Established cardiovascular disease
Exclusion criteria
* Organic, including symptomatic, mental disorders * Mental and behavioural disorders due to psychoactive substance use * Schizophrenia, schizotypal and delusional disorders * Behavioural syndromes associated with physiological disturbances and physical factors * Disorders of adult personality and behaviour * Mental retardation * Disorders of psychological development
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The impact of CMM services on blood pressure in elderly patients with established CVD | 1 year | Within- and between-treatment differences for the intervention and the control group in blood pressure. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The impact of CMM services on LDL cholesterol, triglycerides, HDL cholesterol and total cholesterol in elderly patients with established CVD | 1 year | Within- and between-treatment differences for the intervention and the control group in LDL cholesterol (mmol/L), triglycerides (mmol/L), HDL cholesterol (mmol/L) and total cholesterol (mmol/L). |
| The impact of CMM services on health care utilization in elderly patients with established CVD | 1 year | Between-treatment difference in the number of hospital admissions, emergency department visits and unplanned GPs visits. |
| The impact of CMM services on drug therapy problems in elderly patients with established CVD | 1 year | Number and type of drug therapy problems in the intervention group. |
| The impact of CMM services on health related quality of life in elderly patients with established CVD assessed by EQ-5D-5L instrument. | 1 year | Change from baseline in health related quality of life assessed by EQ-5D-5L instrument in the intervention group. |
| The impact of CMM services on glycated haemoglobin in elderly patients with established CVD | 1 year | Within- and between-treatment differences for the intervention and the control group in glycated haemoglobin. |
Countries
Croatia
Outcome results
None listed