ACS (Acute Coronary Syndrome), Dyslipidemia, Hyperlipidemia, Low-Density-Lipoprotein-cholesterol Level
Conditions
Keywords
Dyslipidemia, Canadian VIGOUR Centre, LDL, ACS, triglycerides, lipid
Brief summary
The purpose of this study is to determine whether a proactive, EHR-guided approach helps more individuals reach safe cholesterol levels, improves medication use, and reduces future heart attacks and strokes, compared to usual care. The main question it aims to answer is: • Does the EHR-LOCALE pathway increases the proportion of patients who reach the LDL-cholesterol target of \<1.8 mmol/L at 6 months? Participants in the interventional group receive: * Pharmacist contact * Repeat lipid requisitions * Review of medications, adherence, and side effects * Treatment escalation according to national dyslipidemia guidelines
Detailed description
After a heart event, such as a heart attack, many people never reach the cholesterol levels needed to lower their risk of experiencing another heart event even with good care. This research study is evaluating a new way to better support patients in reaching those targets. The EHR-LOCALE study uses Alberta's electronic health record (EHR) to automatically identify these individuals and offer them extra support. Those who are not at their cholesterol target are contacted by a pharmacist, who can order blood tests, review medications, and adjust treatment according to national guidelines. This project tests whether this proactive, EHR-guided approach helps more patients reach safe cholesterol levels, improves medication use, and reduces future heart attacks and strokes, compared to usual care. Ultimately, it aims to make cholesterol management after a heart event more consistent, equitable, and effective.
Interventions
OTHERPharmacist-led lipid optimization pathway
Referral to a centralized, pharmacist-led, telephone clinic for optimization of dyslipidemia management
Sponsors
University of Alberta
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
1. Adults over the age of 18 2. Resident of Alberta 3. Individuals hospitalized with an acute coronary syndrome and have undergone coronary angiography. 4. Able to participate in follow-up contact if randomized to the intervention arm
Exclusion criteria
1\. In-hospital mortality
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Proportion of individuals who achieve guideline recommended low-density-lipoprotein (LDL) cholesterol target of <1.8 mmol/L at 6-months | From enrollment to the end of intervention at 6 months |
Secondary
| Measure | Time frame |
|---|---|
| Proportion of individuals with repeat lipid panel testing at 3-months and 6-months | From enrollment to the end of intervention at 6 months |
| Proportion of individuals who undergo escalation or addition of new of lipid lowering therapies | From enrollment to the end of intervention at 6 months |
| Absolute difference in lipid values (LDL-C, high-density lipoprotein-cholesterol [HDL-C], non-HDL cholesterol, triglycerides) at six-months | From enrollment to the end of intervention at 6 months |
| Composite of all-cause mortality, hospitalization for myocardial infarction, hospitalization for stroke and unplanned coronary revascularization at one-year and five-years | From enrollment to 1 year and 5 years |
Countries
Canada
Contacts
CONTACTCanadian VIGOUR Centre
PRINCIPAL_INVESTIGATORPishoy Gouda, MD
University of Alberta
Outcome results
None listed