Home medicines reviews following acute coronary syndrome: study protocol for a randomized controlled trial

Background: Despite continual improvements in the management of acute coronary syndromes, adherence to guideline-based medications remains suboptimal. We aim to improve adherence with guideline-based therapy following acute coronary syndrome using an existing service that is provided by specifically trained pharmacists, called a Home Medicines Review. We have made two minor adjustments to target the focus of the existing service including an acute coronary syndrome specific referral letter and a training package for the pharmacists providing the service.Methods/Design: We will be conducting a randomized controlled trial to compare the directed home medicines review service to usual care following acute coronary syndromes. All patients aged 18 to 80 years and with a working diagnosis of acute coronary syndrome, who are admitted to two public, acute care hospitals, will be screened for enrolment into the trial. Exclusion criteria will include: not being discharged home, documented cognitive decline, non-Medicare eligibility, and presence of a terminal malignancy. Randomization concealment and sequence generation will occur through a centrally-monitored computer program. Patients randomized to the control group will receive usual post-discharge care. Patients randomized to receive the intervention will be offered usual post-discharge care and a directed home medicines review at two months post-discharge. The study endpoints will be six and twelve months post-discharge. The primary outcome will be the proportion of patients who are adherent to a complete, guideline-based medication regimen. Secondary outcomes will include hospital readmission rates, length of hospital stays, changes in quality of life, smoking cessation rates, cardiac rehabilitation completion rates, and mortality.Discussion: As the trial is closely based on an existing service, any improvements observed should be highly translatable into regular practice. Possible limitations to the success of the trial intervention include general practitioner approval of the intervention, general practitioner acceptance of pharmacists' recommendations, and pharmacists' ability to make appropriate recommendations. A detailed monitoring process will detect any barriers to the success of the trial. Given that poor medication persistence following acute coronary syndrome is a worldwide problem, the findings of our study may have international implications for the care of this patient group.Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12611000452998. © 2012 Bernal et al; licensee BioMed Central Ltd

Effect of Dodonaea viscosa Jacq. residues on growth and yield of mungbean (Vigna mungo L. Hepper)

This study was to evaluate the effect of Dodonaea viscosa Jacq. residues on mungbean (Vigna mungo L.Hepper) local cultivar. An experiment [using randomized complete block design (RCBD) design] with three replications was conducted in 2010. The trial comprised of four treatments such as mulching, incorporation into soil and extract, along with control with mungbean crop without adding residues of D. viscose. Data showed a significant increase in chlorophyll - b (Chl.b) and total chlorophyll in leaves of mungbean in mulching treatment as compared to control. Plant height, number of branches per plant, leaf area index, number of seed per pod and 100 seed weight were slightly higher for D. viscosa residues than for the control treatment. All D. viscosa residues treatments had positive effects on number of pods per plant, plant seed yield and total seed yield as compared to control. However, mulching treatment was the superior. Neither protein nor oil content in mungbean seeds were significantly affected by D. viscosa residues, even though there was slight increase. Carbohydrates content in the seeds were not significantly different due to D. viscosa residues treatments, although some decrease was observed due to slight increase in protein and oil content. The leaf tissue N, P, K, Mg or Fe concentrations were not significantly affected by D. viscosa residues treatments. However, the chemical analysis of field soil properties after harvesting demonstrated the increase in inorganic elements as compared with soil before sowing. Mulching gave the best results, followed by incorporation into the soil, and then spraying of extract in comparison to control.Keywords: Mungbean, Dodonaea viscosa residues, growth, yield, quality, mineral elements content.African Journal of Biotechnology, Vol 13(24) 2407-241