Description

Clinical trials have shown us that patients with type 2 diabetes can reap substantial benefits from interventions targeted at risk factors beyond glycemic control. Despite these clinical successes – and strong advocacy from national organizations – uptake of clinical guideline recommendations into daily practice is suboptimal.

In addition, numerous studies have shown that optimal management of hypertension, hypercholesterolemia, and hyperglycemia in people with type 2 diabetes often requires complex medication regimens. Because of these complex regimens, the potential for drug interactions and low adherence rates is quite possible. Pharmacists can be an integral member of the primary care team because of their recognized drug therapy knowledge. Pharmacists can take responsibility for reviewing the patient’s medication profile to help ensure optimal use of medications through drug therapy recommendations, monitoring for therapeutic outcomes, and providing patient education.
The Vascular Intervention Program will investigate the efficacy of an intervention program designed to optimize medication management of cardiovascular risk in people with type 2 diabetes in Alberta. Pharmacists will work within the well-established framework of pharmaceutical care, collaborate closely with physicians and other health care professionals, and make medication management recommendations based on national clinical practice guidelines. In addition, the patient’s perceived barriers to medication use will be addressed. The pharmacist is working with primary care clinics affiliated with the South Side Edmonton Primary Care Network to identify and recruit patients with type 2 diabetes. Individuals who consent to participate are randomized to an appointment within the next month or after a 12-month period. The primary outcome is the proportion of patients achieving a 10% reduction in blood pressure; representing a clinically important improvement in cardiovascular risk management that has been used in recent studies. Cost-effectiveness of the intervention program will be evaluated from the perspective of a government-funded health care system. Humanistic outcomes, in terms of patient satisfaction and health related quality of life, will be evaluated using established surveys.

Research Team

Scot Simpson, Sumit Majumdar, Ross Tsuyuki, Jeff Johnson

Funding

Institute of Health Economics
Canadian Diabetes Association