The Collaborative Cardiovascular Risk Reduction in Primary Care (CCARP) Study
Bibliographic record
Abstract
STUDY OBJECTIVE: To evaluate whether a simple pharmacist protocol, consisting of patient screening and cardiovascular risk stratification, identification and reminders about uncontrolled risk factors, and drug adherence support, can significantly reduce cardiovascular risk. DESIGN: Prospective, randomized, controlled pilot study. SETTING: Large primary care medical clinic in Saskatoon, Saskatchewan, Canada. PATIENTS: One hundred seventy-six adult patients (mean age 60 yrs) who exhibited a 10-year Framingham risk score of 15% or greater, or a coronary artery disease risk equivalent (coronary artery disease, peripheral artery disease, cerebrovascular disease, or diabetes mellitus). INTERVENTION: Eligible patients initially met with the pharmacist to receive general counselling about cardiovascular disease and were then randomly assigned to receive ongoing follow-up by the pharmacist (follow-up group [88 patients]) or to return to usual care (single-contact group [88 patients]) for a minimum of 6 months. MEASUREMENTS AND MAIN RESULTS: The primary end point was mean reduction in the 10-year Framingham risk score. Secondary end points included individual modifiable risk factors (systolic and diastolic blood pressures; total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol [HDL], and triglyceride levels; total cholesterol:HDL ratio; and hemoglobin A(1c) value), as well as statin utilization, initiation, and adherence rates. Baseline characteristics were similar across both groups. Neither the mean reduction in 10-year risk (-2.68 for the follow-up group and -1.25 for the single-contact group, one-tailed p=0.098) nor individual risk factors were significantly different between groups. The proportion of patients exhibiting statin adherence of 80% or greater did not significantly differ between groups at study end (73.1% [57/78] and 80.0% [52/65], respectively, p=0.333). However, 85.2% (75/88) in the follow-up group continued with statin therapy at the end of the study compared with 67.0% (59/88) in the single-contact group (p=0.005). Statin initiations were more frequent in the follow-up group than in the single-contact group (75.0% [30/40) vs 48.9% [22/45], p=0.013). CONCLUSION: This simple cardiovascular care protocol for nonspecialist pharmacists did not result in a clear improvement to cardiovascular risk reduction success among patients in a primary care medical clinic. The intervention did, however, appear to improve statin utilization.
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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 | 0.005 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 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".