Community Pharmacists Assisting in Total Cardiovascular Health (CPATCH): A Cluster‐Randomized, Controlled Trial Testing a Focused Adherence Strategy Involving Community Pharmacies

Blackburn, David; Evans, Charity; Eurich, Dean T.; Mansell, Kerry; Jorgenson, Derek; Taylor, Jeff; Semchuk, William; Shevchuk, Yvonne; Rémillard, Alfred J.; Tran, David; Champagne, Anne

doi:10.1002/phar.1831

Cited by 10 publications

(12 citation statements)

References 23 publications

(30 reference statements)

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“… 25 – 32 Three studies found no overall effect on adherence. 33 – 35 Two studies found a significant gender-specific intervention effect, 31 , 34 whilst the other nine studies found no gender-specific effects, ie, the intervention was equally effective (or ineffective) for men and women. Four studies were multicomponent studies versus eleven single component studies (see Table 1 ).…”

Section: Resultsmentioning

confidence: 98%

“…Patients were asked to respond whether they had taken their medication, whether the text reminded them, and the reason if they had not taken their medication. Ineffective Interventions (neither a gender-neutral nor a gender-specific intervention effect) Blackburn, 2016 Canada 35 Cluster RCT 1,906 new statins users. Intervention group: n=907 (♀ n=447) Control group: n=999 (♀ n=431) Type: single component; counseling Setting: community pharmacy Aim: prevent nonadherence during the first year of statin use Two brief screening questions: 1) “How long have you been taking this medication?” 2) (example) “Are you having any difficulties or concerns with this new medication?” Pharmacists were challenged to personalize the second screening question.…”

Section: Resultsmentioning

confidence: 99%

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<p>Interventions to Improve Adherence to Cardiovascular Medication: What About Gender Differences? A Systematic Literature Review</p>

Vervloet¹,

Korevaar²,

Leemrijse³

et al. 2020

PPA

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Background Compared to men, women have lower treatment rates for cardiovascular disease (CVD), are at higher risk for medication non-adherence and have different reasons for being non-adherent. The aim of this study was to synthesize and evaluate gender-specific adherence-promoting interventions for cardiovascular medication and gender-specific effects of gender-neutral interventions. Methods A systematic literature search was performed in PubMed, Embase, PsycINFO, CINAHL and Cochrane Library from January 2007 to October 2019. Intervention studies (with control group) aimed at improving cardiovascular medication adherence with minimally 14 weeks follow-up were included. Two reviewers independently screened titles and abstracts. Full text was obtained for selected abstracts and screened for final inclusion. Data extraction included gender-specific targeting or analysis. Results The search identified 6502 citations. After screening title and abstract, full text was obtained from 127 potentially eligible articles. Ultimately, 11 articles were included that analyzed gender differences in gender-neutral interventions. Two reported a gender-specific intervention effect. Using an electronic reminder device, one study increased statin adherence in women. The other found a larger increase in adherence to CVD medication following telephone counseling for men than women. Nine studies did not identify a gender-specific effect. Conclusion Despite differences in levels of and reasons for non-adherence, most studies addressing adherence did not analyze potential differences in effect by gender. Moreover, none of the identified studies used gender-specific adherence promoting interventions. Increasing awareness about gender differences in adherence might lead to better tailoring of interventions to gender-specific needs and better results in improving adherence.

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

<p>Interventions to Improve Adherence to Cardiovascular Medication: What About Gender Differences? A Systematic Literature Review</p>

Vervloet¹,

Korevaar²,

Leemrijse³

et al. 2020

PPA

View full text Add to dashboard Cite

show abstract

“…The median Cochrane risk of bias score by individual paper was 50.0% (IQR 33.3–66.7). Only one paper met all criteria of the Cochrane tool and two papers did not meet any. The median CONSORT score was 59.5% (IQR 52.0–70.3%) with three papers meeting 83.8% of the criteria and one meeting only 29.7% .…”

Section: Resultsmentioning

confidence: 99%

Do randomised controlled trials relevant to pharmacy meet best practice standards for quality conduct and reporting? A systematic review

Ritchie

Seubert

Clifford

et al. 2019

International Journal of Pharmacy Practice

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Objectives Evidence-based pharmacy practice requires a dependable evidence base. Randomised controlled trials (RCTs) are the gold standard of high-quality primary research, and tools exist to assist researchers in conducting and reporting high-quality RCTs. This review aimed to explore whether RCTs relevant to pharmacy are conducted and reported in line with Cochrane risk of bias and CONSORT standards, respectively. Methods A MEDLINE search identified potential papers. After screening of titles, abstracts and full texts, the 50 most recent papers were reviewed and assessment of bias according to Cochrane domains and compliance with CONSORT checklist items was recorded. Each domain of the Cochrane tool and CONSORT checklist item and each article were given a percentage score, reported as median and interquartile range (IQR). Correlation between quality of conduct, quality of reporting, continent of origin, and journal impact factor was conducted using the R 2 statistic. The median domain score for risk of bias by paper according to the Cochrane risk of bias tool was 53.0% (IQR 38.5-68.5), while the median compliance score by paper for the CONSORT checklist was 64.0% (IQR 36.0-94.0%). Key findings The median Cochrane domain and median CONSORT item completion scores, respectively, were 50.0% (IQR 33.3-66.7%) and 59.5% (IQR 52.0-70.3%). The highest risk of bias was associated with allocation concealment and blinding, and the least well-reported items were randomisation details, sequence generation and allocation concealment. A positive relationship between conduct and reporting of RCTs was found (R 2 = 0.75), while no correlation was found between quality of conduct or quality of reporting and journal impact factor, correlation coefficients (R 2 = 0.06 and R 2 = 0.05, respectively). Summary This review identified that issues related to randomisation and blinding are often inadequately conducted or not comprehensively reported by researchers conducting pharmacy relevant RCTs, providing useful information for education and future research.

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“…Collaborating with all relevant stakeholders in services research and development, with the patients’ best interest as the main priority, will require a change of mindset on both individual and organizational level. Allowing community pharmacists to fully engage in services provision and research, and providing them with enough information and support to do so can ultimately make the significant difference regarding patient outcome …”

Section: Discussionmentioning

confidence: 99%

“…Allowing community pharmacists to fully engage in services provision and research, and providing them with enough information and support to do so can ultimately make the significant difference regarding patient outcome. [35] From a professional perspective, the pharmacists regard themselves as lacking the competence required for CPS provision and research, but also as overqualified for their regular day-to-day activities. They appear to need CPSs and CPS research to allow them to use their skills, properly counsel patients and develop professionally.…”

Section: Discussionmentioning

confidence: 99%

Competence, competition and collaboration: Perceived challenges among Swedish community pharmacists engaging in pharmaceutical services provision and research

Frisk

Holtendal

Bastholm‐Rahmner

et al. 2019

International Journal of Pharmacy Practice

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Background Creating evidence of effectiveness is an important part of service development. In an ongoing research project Swedish community pharmacists participate in services research by recruiting patients initiated on statins to an adherence‐promoting cognitive pharmaceutical service, jointly run by nurses and pharmacists. Aims To explore the pharmacists’ experiences of providing part of the service and their views regarding future participation in practice research aiming at developing cognitive pharmaceutical services. Methods Focus group interviews were conducted with community pharmacists from pharmacies participating in the project. A semi‐structured interview guide was developed, based on the aim and earlier research. Results The domains identified were the service itself, operative conditions, the pharmacists’ role/profession and stakeholders. The research project was thought to promote the local pharmacy to customers, increase job satisfaction and contribute to service development. However, a perceived lack of competence among pharmacists affected both patient communication and project involvement. Additional resources and strengthened collaboration with other local healthcare were requested. Competition among pharmacy chains was identified as a barrier to patient‐centred service provision and research. Conclusion The current operative conditions in Swedish community pharmacies were perceived by pharmacists as hampering cognitive pharmaceutical services provision and research. Additional resources, improved communication skills and research competence, and increased collaboration with other healthcare and across pharmacy chains are necessary changes. A stronger patient‐centred perspective among all stakeholders is required.

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Community Pharmacists Assisting in Total Cardiovascular Health (CPATCH): A Cluster‐Randomized, Controlled Trial Testing a Focused Adherence Strategy Involving Community Pharmacies

Abstract: The CPATCH intervention was ineffective for improving patient adherence to statin therapy in community pharmacies. However, poor effectiveness may have resulted from a failure to deliver the protocol consistently in several intervention pharmacies.

Cited by 10 publications

References 23 publications

<p>Interventions to Improve Adherence to Cardiovascular Medication: What About Gender Differences? A Systematic Literature Review</p>

<p>Interventions to Improve Adherence to Cardiovascular Medication: What About Gender Differences? A Systematic Literature Review</p>

Do randomised controlled trials relevant to pharmacy meet best practice standards for quality conduct and reporting? A systematic review

Competence, competition and collaboration: Perceived challenges among Swedish community pharmacists engaging in pharmaceutical services provision and research

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