A Partnership between community pharmacists and general practitioners in the management of ischaemic heart disease: a feasibility study
Bibliographic record
Abstract
AIM • To explore the feasibility of pharmacist involvement in the management of patients with stable angina, when working with general practitioners (GPs). DESIGN • Protocol guided management of patients with stable angina. The study involved two face-to-face reviews conducted in general practices at the beginning and end of the five-month study and two brief interim telephone reviews. The patient reviews concentrated on six evidence-based interventions: smoking cessation, dietary advice, exercise, aspirin, beta-blockers and statins. SUBJECTS AND SETTING • The feasibility study was undertaken by five community pharmacists working in eight general practices within St Helens and Knowsley Health Authority, an area with a high ischaemic heart disease standardised mortality rate. 327 patients with stable angina (grades I-III, Canadian Cardiovascular Society classification criteria) were invited to participate in the study. OUTCOME MEASURES • Changes in: patient management across the six evidence-based interventions; angina grade assessed using the Canadian Cardiovascular Society classification criteria; quality of life and functional status assessed using the Seattle Angina Questionnaire. RESULTS • 236 (72%) of the invited patients participated in the study. 208 (88%) remained in the study until completion. Their mean age was 65 years (44-77 years); 94 (40%) were female and 142 (60%) were male. 105 therapeutic interventions were suggested by the pharmacists following the first patient reviews. 93 (89%) were accepted and included those relating to the sub-optimal use of nitrates. Improvements were seen as a consequence of both therapeutic and lifestyle interventions, the outcome of which was improved disease specific quality of life. CONCLUSIONS • The community pharmacists demonstrated their ability to work with general practitioners to deliver a specified model of care for the secondary prevention of ischaemic heart disease.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.027 | 0.022 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".