R T Tsuyuki

..Since most patients were still not at the target LDL level, this finding suggests that continuing intervention is necessary to help patients reach this target...

..Therefore, we attempted to conduct a pilot study to evaluate the feasibility of undertaking a large randomized controlled trial with clinical endpoints...

..If our intervention improves the provision of secondary prevention therapies in these patients, the clinical (and financial) implications will be enormous...

..CONCLUSION: If the methods used in this intervention are found to improve prescribing practices, similar interventions could be designed for other chronic conditions dealt with in the outpatient setting...

..Congestive heart failure (CHF) is associated with high morbidity and mortality; however, there is little contemporary Canadian data to quantify the burden of this illness...

..This study aimed to determine the effect of a program of community pharmacist intervention on the process of cholesterol risk management in patients at high risk for cardiovascular events...

..The objective of this study was to prospectively describe the precipitants associated with exacerbation of CHF status in patients enrolled in the Randomized Evaluation of Strategies for Left Ventricular Dysfunction Pilot Study...

..With Alberta being the first province in Canada to have independent prescribing by pharmacists, it offers a unique opportunity to evaluate outcomes in patients who are prescribed antihypertensive therapy by pharmacists...

..Lower extremity peripheral arterial disease (PAD) is underdiagnosed and undertreated in Canada, although data are limited. We sought to measure PAD prevalence and treatment patterns in ambulatory settings...

..To determine the efficacy of a program of intervention by pharmacists on lipid risk management in patients at high risk for cardiovascular events...

..The incremental cost to provide the program appeared minimal from both government and pharmacy manager perspectives. It is hoped that these results could support negotiations for reimbursement of clinical pharmacy services with payors...

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..Results of this substudy suggest that pharmacists should target this patient group for interventions in cholesterol risk management...

..To determine the impact of adding pharmacists to primary care teams on predicted 10-year risk of cardiovascular events in patients with Type 2 diabetes without established cardiovascular disease...

..CONCLUSIONS: Metformin, alone or in combination, in subjects with heart failure and type 2 diabetes was associated with lower morbidity and mortality compared with sulfonylurea monotherapy...

..Programs to improve the quality of cardiovascular risk reduction in these high-risk patients are needed...

..030), hospitalization days (812 versus 341, P = .003), and cost of care (2,531 Canadian dollars less per patient) in favor of the PSP. CONCLUSION: Simple interventions can improve ACE inhibitor use and patient outcomes...

..Conclusion. The BMU survey demonstrated reasonable reliability and validity characteristics in this first clinical experience. Despite high adherence, patients still reported barriers that may hinder optimal drug use...

..The purpose of this study was to evaluate perceptions among healthcare stakeholder groups relating to the barriers and facilitators of implementing a PHM programme...

..Although reversal of pretransplant renal dysfunction in hepatorenal syndrome reduces post-transplant complications, the overall impact on morbidity and mortality requires clarification...

..We evaluated the impact of a CRRC on lipid levels and assessed the long-term effect of a CRRC in maintaining improved lipid levels following discharge...

..To evaluate the effect of adding pharmacists to primary care teams on the management of hypertension and other cardiovascular risk factors in patients with type 2 diabetes...

..To evaluate the relation between adherence to drug therapy, including placebo, and mortality...

..Further efforts to package, deliver and evaluate guidelines are needed...

..We aimed to examine the individual and contextual factors perceived by patients and their informal caregivers' to influence their willingness and capacity to undertake effective HF self-care...

..We evaluated whether evidence summaries, which were either unsigned or signed by local opinion leaders, improved the quality of secondary prevention care delivered by primary care physicians of patients with coronary artery disease...

..The cause of the "treatment-risk paradox" reported for patients with coronary disease is unknown; however, determining the factors that contribute to this paradox is essential to properly design quality improvement interventions...

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..Twice as many patients who got the intervention received further testing or treatment for osteoporosis...

..To determine the adequacy of hypertension management in institutionalized elderly patients...

..Accounts of HF and its self-care were grounded in work and place-related dimensions of the rural setting. Approaches and interventions related to chronic disease must engage with place and work-related dimensions of context...

..3 million dollars, giving a net savings of 2.3 million dollars in the first year. The implementation of evidence-based therapy for CHF treatment is not only clinically efficacious, but also economically attractive...

..Trials evaluating angiotensin-receptor blockers in heart failure (HF) have shown inconsistent results...

..Second, it provides needed data to demonstrate the value of enhanced pharmacy practice. Thorough understanding of pharmacists' opinions is necessary to optimize the design of future studies...

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..Until further information specifically dealing with this issue is available from large prospective trials, our findings may alleviate recent concerns over the safety of this class of medications...

..To quantify the cost-savings that could be realized by switching patients from two separate agents, ACE inhibitor/ARB and thiazide diuretic, to a fixed dose combination product...

..This suggests a need for more-aggressive approaches to the management of cholesterol, particularly in high-risk patients...

..To review the literature on the association between antidiabetic agents and morbidity and mortality in people with heart failure and diabetes...

..44-0.90]; P = 0.012). CONCLUSIONS: The use of ACE inhibitors was associated with a significant reduction in all-cause and cardiovascular-related mortality in a broad spectrum of patients with type 2 diabetes and no cardiovascular disease...

..More data are needed before statins can be recommended in those with isolated heart failure...

..928). An abnormal T axis was a significant predictor of overall mortality (p = 0.035) for death at any time in our unadjusted survival analysis, and a trend toward poorer survival persisted after adjustment for clinical covariates...

..Efforts to increase the utilization of evidence-based therapies and improve monitoring are warranted...

..The same relation was not observed with metformin. This implies that the manner in which blood glucose concentration is lowered may be as important as achieving recommended glucose targets...

..Narrowing this gap between research evidence and clinical practice may be accomplished by identifying those patients who are eligible for prophylaxis, and then maintaining them at an adequate level of anticoagulation...

..While the search for new, efficacious therapies must continue, efforts focused on improving adherence to proven therapy may have a greater overall impact on health than any single new agent...

..The objective of this study was to examine the construct validity of the RAND-12 and HUI3 in the context of high-risk primary care patients...

..We sought to determine whether collaborative care including a team-based clinical pharmacist improves the quality of prescribed drug therapy and reduces hospital readmission...

..In our cohort of elderly patients with multiple comorbidities, beta-blockers were well tolerated...

..This study aimed to determine the efficacy of a community-based multidisciplinary intervention on BP control in patients with diabetes mellitus...

..The use of decision support technologies would facilitate involvement of the patient and serve to educate both the patient and physician on the risks and benefits of warfarin therapy...

..To clarify the role of pharmacists in the care of patients with HF, we performed a systematic review evaluating the effect of pharmacist care on patient outcomes in HF...

..Heart failure (HF) is a common emergency depart-ment (ED) presentation and a leading reason for hospitalization. Canadian practice patterns for the management of acute HF have not been well described...

..Understanding perceived barriers to and facilitators of PHM implementation may support the expansion of programs, with associated patient benefit...

..CONCLUSIONS: Our study indicates a gap in the provision of asthma education, written action plans, and spirometric testing for patients diagnosed with asthma among primary care physicians...

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..Well-conducted systematic reviews of pharmacist interventions could go a long way toward changing pharmacy practice and healthcare policy to recognize the important impact that pharmacists could have in the healthcare system...

..There is a need for systematic identification of appropriate candidates for anticoagulation in the long-term care setting...

..INTERPRETATION: This new evidence lends support to practice guidelines, which recommend revascularization in patients with heart failure and coronary disease...

..However, there is a paucity of randomized, double-blind, controlled trials assessing the efficacy of these agents...

..Focussed attention on how practice is structured, team process and ongoing support would enable successful implementation of team-based care in a larger context. (ClinicalTrials.gov number, NCT00351676)...

..Our objective was to determine if pharmacists, using a simple screening questionnaire, can identify individuals with previously undiagnosed knee OA...

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..Communication between community-based providers is often sporadic and problem-focused...

..The goal is to translate best evidence-based therapies into clinical practice with a measureable impact on the health of heart failure patients in Canada...

..CONCLUSIONS: Although Canadian pharmacists' capabilities are not yet universally recognized and applied to their full potential, there is reason to be optimistic about the future of pharmaceutical care in the community setting in Canada...

..Inconsistencies in rural and urban health care exist; however, little has been done to evaluate the potential differences in asthma management...

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..CONCLUSION: There has been a relatively rapid uptake of LMW heparins and outpatient treatment for DVT in their early years of availability, but the pace of uptake has varied considerably across hospitals and countries...

..CONCLUSIONS: The PA process may have delayed patients filling clopidogrel prescriptions following hospital discharge and has the potential to contribute to negative clinical consequences...