Monitoring and Adjustment of Medication Therapy for Patients With Heart Disease

Status unconfirmed · Not applicable

Conditions studied: Coronary Heart Disease, Myocardial Infarction

In brief

Existing trials for the patient with coronary heart disease evaluate the interdisciplinary team dynamic where pharmacists (pharmacotherapists) provide therapeutic recommendations in the inpatient environment. To our knowledge, only other trial has evaluated the addition of a pharmacist (or nurse practitioner) in an outpatient collaborative cardiology practice and has found no benefit. However, the investigators believe that since a cardiology based pharmacist (pharmacotherapist) in the Veterans Health Administration has physical assessment skills, a shorter cycle length between appointments, and the ability to provide medication therapy management, the pharmacotherapist should be similarly successful as seen with other pharmacist based medication therapy management practices. The investigators will assess effectiveness by using the combined endpoint of blood pressure and lipid treatment. Additionally the investigators will conduct three substudies to evaluate if the pharmacist can improve all cause mortality and cardiovascular morbidity, adherence to antihypertensives, and patient satisfaction.

Key facts

Study ID

NCT01427218

Run by

Middle Tennessee Research Institute

People needed

170

Starts

2010-11-01

Expected to finish

2012-12-01

Last updated by the study team

2011-09-01

Who can join

Age: 60 and older, up to 90. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• All patients with a diagnosis of ACS at the VA Tennessee Valley Healthcare System who
• are greater than or equal to 60 years of age
• will benefit from Medication Therapy Management (MTM):
• Have a baseline LDL >79mg/dL in the first 24 hours of acute coronary syndrome (ACS) OR if LDL not assessed in the first 24 hours of ACS, have a recent LDL >79mg/dL (in the last 15 months) OR not have an LDL assessed prior to or during admission.
• AND
• Have outpatient blood pressures (BP) above goal on 65% or more of assessments within the last 15 months or a SBP >140mmHg or DBP>90mmHg or both on the last outpatient BP assessment.
• are enrolled or will be enrolled in outpatient cardiovascular services at the VA Tennessee Valley Healthcare System

You may not qualify if…

• Patients who
• are transferred to a long-term care facility or skilled nursing facility
• are assigned to another Veterans Health Administration medical center,
• have a discharge primary or secondary discharge diagnosis code for dementia, schizophrenia, or organic brain syndrome,
• cannot speak or understand English or give written informed consent,
• are enrolled in hospice or palliative care
• are participating in another trial that prohibits participation in this trial
• have a baseline LDL> 200mg/dL in proximity to admission suggestive of familial hypercholesterolemia (FH) or a known diagnosis of FH
• require clonidine or minoxidil for blood pressure control prior to the index admission
• are enrolled in the Nashville preventative cardiovascular clinic for hypertension
• have a urinary drug screen positive for cocaine in the last 12 months
• have plans to move in the next 6 months

Where it is running

• VA Tennessee Valley Healthcare System — Nashville, Tennessee, United States (enrolling)

Full record on ClinicalTrials.gov

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