OBJECTIVES: Evaluate the efficacy of family physician-community pharmacist collaborative care (PPCC) in which pharmacists are responsible for titrating lipid-lowering pharmacotherapy. METHODS: 15 clusters comprising 77 physicians and 108 pharmacists were randomly assigned to the PPCC or the usual care (UC) group. A total of 108 PPCC and 117 UC patients were followed for 12 months. PPCC pharmacists provided counselling; requested laboratory tests; monitored effectiveness, safety, and adherence to treatment; and adjusted medication dosage. Change in low-density lipoprotein cholesterol (LDL-C) level (primary outcome), proportion of patients reaching their target lipid levels and changes in other risk factors were assessed at month 12. RESULTS: At baseline, PPCC patients had higher LDL-C (3.5 versus 3.2 mmol/L;p=0.05). During the study, they were less likely to receive high-potency statin (11.1% versus 39.7%), had more health-professional visits and laboratory tests, were more likely to have their lipid-lowering treatment changed, and to report lifestyle changes. At 12 months, the difference in the crude and the adjusted mean change in LDL-C between the PPCC and the UC groups was equal to -0.2 mmol/L (95%CI: -0.3 to -0.1) and -0.04 (95%CI: -0.3 to 0.2), respectively. The crude and the adjusted relative risk of achieving lipid targets were equal to 1.10 (95%CI: 0.95 to 1.26) and  1.16 (1.01 to 1.32), respectively. CONCLUSIONS: Collaborative practice can be implemented in primary care.  Among patients with modest dyslipidemia, this study provides no evidence of a significant clinical impact on lipid control.