Implementation of a pharmacist-led intervention to enhance statin prescribing for secondary prevention in primary care: A cluster randomized trial

Abstract

Background: Although statins have indisputably proven to reduce fatal and nonfatal events in patients with cardiovascular disease, many patients with established cardiovascular disease do not receive them. Research into the effective and efficient implementation of current guidelines on secondary prevention is therefore needed.Design: A cluster randomized implementation trial was conducted between September 2006 and February 2008.Methods: Experimental pharmacists received an intensive implementation programme, whereas control pharmacists received an educational manual only. Pharmacists in both the groups were asked to identify eligible patients and to provide general practitioners (GPs) with lists of these patients. Physicians received instructions from the pharmacists to review the patients regarding a statin indication and to start a statin when they considered this as appropriate. Main outcome measure was the percentage of identified patients who received one or more statin prescriptions at 6 months follow-up.Results: Although twice as many patients were reviewed for a statin indication by a GP in the experimental group (19.7 vs. 10.8%, P = 0.023), an equally low number of patients in the experimental group and the control group received statins (5.8 vs. 5.3%, P = 0.104).Conclusion: The intensive implementation programme had an impact on pharmacists and GPs, but did not result in more patients receiving statins. © The European Society of Cardiology 2011 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.