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dc.contributor.advisorTaylor, Jeffen_US
dc.contributor.advisorBlackburn, Daviden_US
dc.creatorEvans, Charity Dawnen_US
dc.date.accessioned2010-11-04T21:12:04Zen_US
dc.date.accessioned2013-01-04T05:07:52Z
dc.date.available2011-11-22T08:00:00Zen_US
dc.date.available2013-01-04T05:07:52Z
dc.date.created2010-10en_US
dc.date.issued2010-10en_US
dc.date.submittedOctober 2010en_US
dc.identifier.urihttp://hdl.handle.net/10388/etd-11042010-211204en_US
dc.description.abstractCardiovascular disease is a leading cause of death and hospitalizations in Canada. Most risk factors for cardiovascular disease are known, and many are modifiable. One such risk factor that often goes unrecognized is non-adherence. Pharmacists are ideally positioned to have an influence on cardiovascular risk reduction, including supporting medication adherence; however it is still unknown whether typical (non-specialist) pharmacists can provide strategies that are effective and sustainable in today’s health care system. Thus, the overall objective of this research project was to determine what interventions typical pharmacists can adopt to effectively facilitate cardiovascular risk reduction within the constraints of the current practice environment. This objective was accomplished through 4 related studies: 1) a randomized controlled trial involving a pharmacist-directed cardiovascular risk reduction collaboration within a family physician practice; 2) a systematic review identifying and evaluating published interventions by community pharmacists for cardiovascular disease or diabetes; 3) the design of a pilot study evaluating a novel community pharmacy intervention aimed at cardiovascular risk reduction and; 4) the examination of adherence patterns among antihypertensive medication users to identify associated factors and high-risk periods for non-adherence. Although the randomized controlled trial did not show a statistically significant benefit of the pharmacist intervention on cardiovascular risk, it did demonstrate the feasibility of incorporating a pharmacist into a collaborative role, without the need for an advanced or specialized degree. Results from the systematic review yielded several studies involving community pharmacists and cardiovascular disease or diabetes. However, the majority of these studies were of poor quality, evaluated complex and intensive interventions, and provided questionable clinical benefits. The design of the pilot study demonstrated the feasibility of developing high quality, robust research involving community pharmacists. Finally, the observational study examining adherence patterns to antihypertensive agents revealed two important findings that can guide the development of future strategies to support adherence: the first year of therapy, and particularly the first dispensation, is a critical time for the development of non-adherence and, contrary to previously published studies, adherence is similar between all classes of antihypertensive medications. This program of research did not identify one particular pharmacist intervention as being superior for cardiovascular risk reduction in today’s practice environment. However, it did highlight the need for improved study quality and the development of interventions that are practical and can be realistically implemented by pharmacists in today’s practice environment.en_US
dc.language.isoen_USen_US
dc.subjectadherenceen_US
dc.subjectcardiovascularen_US
dc.subjectcommunity pharmacyen_US
dc.subjectpharmacyen_US
dc.subjectadministrative dataen_US
dc.titleCardiovascular risk reduction and pharmacy: advancing practice in primary careen_US
thesis.degree.departmentPharmacyen_US
thesis.degree.disciplinePharmacyen_US
thesis.degree.grantorUniversity of Saskatchewanen_US
thesis.degree.levelDoctoralen_US
thesis.degree.nameDoctor of Philosophy (Ph.D.)en_US
dc.type.materialtexten_US
dc.type.genreThesisen_US
dc.contributor.committeeMemberAlcorn, Janeen_US
dc.contributor.committeeMemberShevchuk, Yvonneen_US
dc.contributor.committeeMemberRemillard, Alfreden_US
dc.contributor.committeeMemberEurich, Deanen_US


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