McAlister 2014.
| Methods | Randomised trial | |
| Participants | 279 patients > 18 years who had an ischaemic stroke or transient ischaemic attack confirmed by a stroke specialist at 1 of the 3 stroke prevention clinics (intervention 139: control 136)
Edmonton, Alberta, Canada Hypertension and cholesterol Year of study: 2009 to 2012. |
|
| Interventions | Intervention patients received intensive pharmacist‐led case management, consisting of monthly follow‐up visits with the study pharmacist for 6 months, independent of planned follow‐up with the clinic or family physician. At each visit, the study pharmacist monitored the patient's BP and lipid levels and initiated and/or titrated antihypertensive and/or hypolipidaemic therapy as appropriate. The study pharmacist followed treatment algorithms consistent with Canadian national guidelines. The pharmacist emphasised medication and lifestyle adherence with patients and their caregivers, using the cardiovascular risk profile as an educational aid. The pharmacist also sent a fax to the primary care physician after each visit outlining the status of that patient's atherosclerosis risk factors and any therapy adjustments made. Duration: 6 months |
|
| Outcomes | Systolic blood pressure Low density lipoprotein |
|
| Notes | Funding source: Finlay McAlister and Sumit Majumdar received salary support awards from Alberta Innovates Health Solutions. Finlay McAlister held the University of Alberta Chair in Cardiovascular Outcomes Research. Sumit Majumdar held the Patient Health Management Chair at the University of Alberta. Project‐specific funding for this trial was provided by the Heart and Stroke Foundation of Alberta, the Alberta Heritage Foundation for Medical Research, and Knowledge Translation Canada. Conflict of interest: None of the funders had a role in the design of the study nor in the conduct, analysis, interpretation or reporting of the study, nor access to the data. |
|
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Quote "Randomisation will be done centrally by computer‐generated random numbers, and a secure internet‐based allocation method that ensures allocation concealment" |
| Allocation concealment (selection bias) | Low risk | Quote "Randomisation will be done centrally by computer generated random numbers, and a secure internet‐based allocation method that ensures allocation concealment. As this study is unblinded, variable sized blocked randomisation will also be used to preserve allocation concealment." |
| Blinding of participants and personnel (performance bias) All Outcomes/Outcome 1 | Low risk | All objective outcomes |
| Blinding of outcome assessment (detection bias) All Outcomes/Outcome 1 | Low risk | Quote: "with blinded ascertainment of outcome" Quote: "all outcomes were collected in an independent and blinded manner by observers who were masked to baseline measurements and group assignment." |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | Intention‐to‐treat analysis. Between group attrition = 10%. |
| Selective reporting (reporting bias) | Low risk | Major results reported as planned |
| Other bias | Low risk | None |