Home medicines reviews following acute coronary syndrome: Study protocol for a randomized controlled trial

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dc.contributor.author Bernal, DDL
dc.contributor.author Stafford, L
dc.contributor.author Bereznicki, LRE
dc.contributor.author Castelino, RL
dc.contributor.author Davidson, PM
dc.contributor.author Peterson, GM
dc.date.accessioned 2012-10-12T03:34:33Z
dc.date.issued 2012-04-02
dc.identifier.citation Trials, 2012, 13
dc.identifier.other C1 en_US
dc.identifier.uri http://hdl.handle.net/10453/18710
dc.description.abstract Background: Despite continual improvements in the management of acute coronary syndromes, adherence to guideline-based medications remains suboptimal. We aim to improve adherence with guideline-based therapy following acute coronary syndrome using an existing service that is provided by specifically trained pharmacists, called a Home Medicines Review. We have made two minor adjustments to target the focus of the existing service including an acute coronary syndrome specific referral letter and a training package for the pharmacists providing the service.Methods/Design: We will be conducting a randomized controlled trial to compare the directed home medicines review service to usual care following acute coronary syndromes. All patients aged 18 to 80 years and with a working diagnosis of acute coronary syndrome, who are admitted to two public, acute care hospitals, will be screened for enrolment into the trial. Exclusion criteria will include: not being discharged home, documented cognitive decline, non-Medicare eligibility, and presence of a terminal malignancy. Randomization concealment and sequence generation will occur through a centrally-monitored computer program. Patients randomized to the control group will receive usual post-discharge care. Patients randomized to receive the intervention will be offered usual post-discharge care and a directed home medicines review at two months post-discharge. The study endpoints will be six and twelve months post-discharge. The primary outcome will be the proportion of patients who are adherent to a complete, guideline-based medication regimen. Secondary outcomes will include hospital readmission rates, length of hospital stays, changes in quality of life, smoking cessation rates, cardiac rehabilitation completion rates, and mortality.Discussion: As the trial is closely based on an existing service, any improvements observed should be highly translatable into regular practice. Possible limitations to the success of the trial intervention include general practitioner approval of the intervention, general practitioner acceptance of pharmacists' recommendations, and pharmacists' ability to make appropriate recommendations. A detailed monitoring process will detect any barriers to the success of the trial. Given that poor medication persistence following acute coronary syndrome is a worldwide problem, the findings of our study may have international implications for the care of this patient group.Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12611000452998. © 2012 Bernal et al; licensee BioMed Central Ltd.
dc.language eng
dc.relation.isbasedon 10.1186/1745-6215-13-30
dc.title Home medicines reviews following acute coronary syndrome: Study protocol for a randomized controlled trial
dc.type Journal Article
dc.description.version Published
dc.parent Trials
dc.journal.volume 13
dc.journal.number en_US
dc.publocation United Kingdom en_US
dc.identifier.startpage 1 en_US
dc.identifier.endpage en_US
dc.identifier.endpage 17 en_US
dc.cauo.name FOH.Faculty of Health en_US
dc.conference Verified OK en_US
dc.for 1103 Clinical Sciences
dc.for 1102 Cardiorespiratory Medicine and Haematology
dc.personcode 110950
dc.percentage 50 en_US
dc.classification.name Cardiovascular Medicine and Haematology en_US
dc.classification.type FOR-08 en_US
dc.edition en_US
dc.custom en_US
dc.date.activity en_US
dc.location.activity en_US
dc.description.keywords Acute coronary syndrome, Home medicines review, Medication adherence en_US
dc.description.keywords Science & Technology
dc.description.keywords Life Sciences & Biomedicine
dc.description.keywords Physical Sciences
dc.description.keywords Ecology
dc.description.keywords Marine & Freshwater Biology
dc.description.keywords Oceanography
dc.description.keywords Environmental Sciences & Ecology
dc.description.keywords ECOLOGY
dc.description.keywords MARINE & FRESHWATER BIOLOGY
dc.description.keywords OCEANOGRAPHY
dc.description.keywords Trophic dynamics
dc.description.keywords Resource dependence
dc.description.keywords Ratio dependence
dc.description.keywords Functional response
dc.description.keywords Seagrass
dc.description.keywords Epiphytes
dc.description.keywords Grazers
dc.description.keywords Fish
dc.description.keywords RATIO-DEPENDENT PREDATION
dc.description.keywords COASTAL EUTROPHICATION
dc.description.keywords WATER-QUALITY
dc.description.keywords FISH
dc.description.keywords ECOSYSTEMS
dc.description.keywords AUSTRALIA
dc.description.keywords COMMUNITY
dc.description.keywords HABITATS
dc.description.keywords CASCADES
dc.description.keywords PATTERNS
dc.description.keywords Acute coronary syndrome
dc.description.keywords Home medicines review
dc.description.keywords Medication adherence
pubs.embargo.period Not known
pubs.organisational-group /University of Technology Sydney
pubs.organisational-group /University of Technology Sydney/Faculty of Health
pubs.organisational-group /University of Technology Sydney/Strength - Health Services and Practice Research
utslib.copyright.status Open Access
utslib.copyright.date 2015-04-15 12:23:47.074767+10
utslib.collection.history General (ID: 2)

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