Remote Pharmacist Practice Model of Collaboration in Primary Care
Potential for Benefit or an Opportunity Lost?
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See Article by Carter et al
There is little debate about the direct correlation between the improvement in cardiovascular disease risk factors and outcomes for patients. In fact, the concept of aggressive reduction of the modifiable cardiovascular risks (blood pressure, diabetes mellitus, cholesterol, smoking, body weight, physical activity, and diet) to prevent major adverse cardiovascular events is the major focus of numerous clinical practice guidelines. However, implementing these guidelines, consistently and comprehensively, into clinical practice remains the challenge across practice environments around the world.
In the current context of optimal healthcare delivery, the role of the pharmacist continues to evolve with an increasing emphasis on more global practices in the clinical setting, including an expanded scope of practice, distinct from the traditional dispensing role.1 Consequently, pharmacists have taken on relevant roles and responsibilities for the primary and secondary prevention of cardiovascular diseases across the health system. Systematic reviews of published randomized control trials and observational studies provide evidence that pharmacist interventions result in improved control of diabetes mellitus, dyslipidemia, hypertension, smoking cessation, and hospitalization in patients with heart failure.2 In addition, pharmacist-led, outpatient-based chronic disease management strategies (various disease states in cardiovascular disease risk, diabetes mellitus, dyslipidemia, hypertension, chronic kidney disease, chronic obstructive pulmonary disease, depression, and polypharmacy) are associated with effects similar to those of usual medical care for resource utilization (office visits or emergency department visits and hospitalization) and medication adherence but improved the number or doses of medication received for their condition and improved glycemic, lipid, and blood pressure goal attainment.3
In this issue of Circulation: Cardiovascular Quality and Outcomes, Carter et al4 add to this literature with their cluster randomized trial evaluating the impact of a virtual clinical pharmacy services model compared with usual care on guideline adherence and secondary measures …