AB looks to pharmacists for CVD risk reduction

October 2014 – Alberta has identified vascular risk reduction as a public health priority and has reached out to community pharmacy to demonstrate that pharmacists can play a leading role. “I’ve never been in this position before, where government has come to me to do a study. Usually we’re the ones trying to get their attention,” says Dr. Ross Tsuyuki, pharmacist and Professor of Medicine and Director of the Epidemiology Coordinating and Research (EPICORE) Centre at the University of Alberta.

Alberta Health and Alberta Health Services are co-funding the RxEACH study, a randomized controlled trial that will see pharmacists identify, recruit and work with 1,180 patients who are at high risk of cardiovascular disease (CVD). “What’s unique about this is that we’re treating the patient as a whole, [assessing] their entire risk profile. So it’s not just blood pressure, it’s also smoking cessation, cholesterol, diabetes and chronic kidney disease,” says Tsuyuki.

For patients in the advanced-care group, pharmacists will complete a comprehensive annual care plan or a standard medication management assessment, currently billable as government-funded services, which will include a CVD risk assessment using a validated risk engine (e.g., Framingham Risk Score). The pharmacists will follow up with the patients every three to four weeks for three months to provide ongoing care. At the end of the study period, patients will repeat the CVD risk assessment and results with be compared against the control group.

From the government’s perspective, the role of community pharmacy is particularly appealing because it addresses the growing need to “provide care that is more convenient to where people live, work and play,” says Dr. Norm Campbell, physician and co-lead for Alberta Health Services’ overall vascular risk reduction strategy and professor of medicine at University of Calgary. Campbell has also been awarded the Chair in Hypertension Prevention and Control by the Heart and Stroke Foundation of Canada and the Canadian Institutes for Health Research.

Pharmacists can identify patients who might otherwise fall through the cracks, adds Tsuyuki. “There is always a portion of the population who are not in the system, who don’t see their doctors regularly [or who don’t even have doctors]. Pharmacists can systematically find these patients.”

“Community pharmacy can greatly increase [the healthcare system’s] capacity. This is really a no-brainer,” agrees Campbell.

The RxEACH study is scheduled for completion by July 2015. At that time, pending study results, “there is a strong will to get this out to as many pharmacies as possible,” says Campbell. “In my personal vision, I see this as part of pharmacists’ future routine. I am strongly promoting this role for pharmacists nationwide.”