The purpose of this study is to determine whether a proactive, EHR-guided approach helps more individuals reach safe cholesterol levels, improves medication use, and reduces future heart attacks and strokes, compared to usual care. The main question it aims to answer is: • Does the EHR-LOCALE pathway increases the proportion of patients who reach the LDL-cholesterol target of \<1.8 mmol/L at 6 months? Participants in the interventional group receive: * Pharmacist contact * Repeat lipid requisitions * Review of medications, adherence, and side effects * Treatment escalation according to national dyslipidemia guidelines
After a heart event, such as a heart attack, many people never reach the cholesterol levels needed to lower their risk of experiencing another heart event even with good care. This research study is evaluating a new way to better support patients in reaching those targets. The EHR-LOCALE study uses Alberta's electronic health record (EHR) to automatically identify these individuals and offer them extra support. Those who are not at their cholesterol target are contacted by a pharmacist, who can order blood tests, review medications, and adjust treatment according to national guidelines. This project tests whether this proactive, EHR-guided approach helps more patients reach safe cholesterol levels, improves medication use, and reduces future heart attacks and strokes, compared to usual care. Ultimately, it aims to make cholesterol management after a heart event more consistent, equitable, and effective.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
2,000
Referral to a centralized, pharmacist-led, telephone clinic for optimization of dyslipidemia management
University of Alberta Hospital / Mazankowski Alberta Heart Institute
Edmonton, Alberta, Canada
RECRUITINGUniversity of Alberta Hospital / Mazankowski Alberta Heart Institute
Edmonton, Alberta, Canada
RECRUITINGProportion of individuals who achieve guideline recommended low-density-lipoprotein (LDL) cholesterol target of <1.8 mmol/L at 6-months
Time frame: From enrollment to the end of intervention at 6 months
Proportion of individuals with repeat lipid panel testing at 3-months and 6-months
Time frame: From enrollment to the end of intervention at 6 months
Proportion of individuals who undergo escalation or addition of new of lipid lowering therapies
Time frame: From enrollment to the end of intervention at 6 months
Absolute difference in lipid values (LDL-C, high-density lipoprotein-cholesterol [HDL-C], non-HDL cholesterol, triglycerides) at six-months
Time frame: From enrollment to the end of intervention at 6 months
Composite of all-cause mortality, hospitalization for myocardial infarction, hospitalization for stroke and unplanned coronary revascularization at one-year and five-years
Time frame: From enrollment to 1 year and 5 years
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