Integrating Family Medicine and Pharmacy to Advance Primary Care Therapeutics

NCT00157638 | Completed Phase 4

• 1 other identifier: G03-02671
• Study Type: interventional
• Target: 1,400
• Locations: 1 country
• Sites: 3

Brief Summary

Recent health policy documents have endorsed an integrated model of collaboration between pharmacists and physicians in primary care. The integration of pharmacists into primary care has been identified as a priority for primary health care reform in Canada. However, the best way to do this has not been demonstrated or evaluated. This demonstration project shows the various ways in which pharmacists can be trained and integrated into different family practice settings, the processes and costs associated with doing this, and the outcomes observed. The main hypothesis is that pharmacist integration into family practice will optimize medication use, clinical care and clinical outcomes. This information provides policy makers with necessary information about collaboration between pharmacists and family physicians for their overall goal of reforming the delivery of primary health care to the population.

Conditions

Diabetes; Hypertension; Hyperlipidemia; Constipation; Pain

Keywords

pharmacist; physician; primary care; collaboration; therapeutics

Outcome Measures

Primary Outcomes (8)

• Number and types of patients referred and assessed

• Characterization and quantification of pharmacist activities

• Numbers and types of drug-related problems identified and resolved

• Medication changes made

• Number of recommendations implemented

• Process indicators (measurement of blood pressure, Cholesterol, hemoglobin A1C)

• Surrogate clinical outcomes (values of blood pressure, Cholesterol, hemoglobin A1C)

• Symptom improvement (constipation, pain)

Secondary Outcomes (12)

• Health resource utilization

• Satisfaction with service

• Uptake of pharmacist recommendations

• Extent of knowledge translation

• Extent of collaboration

Interventions

integration of pharmacist into primary care BEHAVIORAL

optimizing therapeutic treatments DRUG

optimizing processes of care BEHAVIORAL

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• + years and any two of the following:
• Elevated blood pressure
• Elevated hemoglobin A1C
• Elevated LDL-C
• Diagnosis of hypertension and no blood pressure readings in past 12 months
• Diagnosis of diabetes and no hemoglobin A1C readings in past 12 months
• Diagnosis of hyperlipidemia and no cholesterol readings in past 12 months
• Diagnosis of osteoarthritis or rheumatoid arthritis
• Using narcotics
• Diagnosis of hypertension, diagnosis of diabetes and not using an ACE inhibitor
• Diagnosis of hypertension, elevated blood pressure and using an NSAID
• Diagnosis of hyperlipidemia, elevate dLDL-C and not using a lipid lowering agent
• Diagnosis of hypertension, high blood pressure and not using a potassium wasting diuretic

You may not qualify if:

• Less than one visit to family physician in past 12 months
• More than 20 visits to family physician in past 12 months
• Awaiting placement to a nursing home or long-term care facility
• Alcoholism
• Palliative care patient
• Family physician only sees patient as a home visit

Sponsors & Collaborators

• Hamilton Health Sciences Corporation: lead

Study Sites (3)

McMaster University

Hamilton, Ontario, L8N 1G6, Canada

Location

University of Ottawa

Ottawa, Ontario, K1N 5C8, Canada

Location

University of Toronto

Toronto, Ontario, M5S 2S2, Canada

Location

MeSH Terms

Conditions

Diabetes Mellitus; Hypertension; Hyperlipidemias; Constipation; Pain

Condition Hierarchy (Ancestors)

Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases; Vascular Diseases; Cardiovascular Diseases; Dyslipidemias; Lipid Metabolism Disorders; Signs and Symptoms, Digestive; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Neurologic Manifestations

Study Officials

• Lisa Dolovich, PharmD, MSc

  McMaster University

  PRINCIPAL INVESTIGATOR

• Kevin Pottie, MD

  University of Ottawa, Ottawa ON

  PRINCIPAL INVESTIGATOR

• Janusz Kaczorowski, PhD

  McMaster University

  PRINCIPAL INVESTIGATOR

• Barbara Farrell, PharmD

  Elisabeth Bruyere Research Institute, Ottawa, ON

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 4
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: ECT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER

Study Record Dates

• First Submitted: September 8, 2005
• First Posted: September 12, 2005
• Study Start: February 1, 2004
• Study Completion: July 1, 2006
• Last Updated: September 11, 2006

Record last verified: 2006-09

Locations

CA (3)