Clinical and humanistic outcomes of a lipid management program in the community pharmacy setting

Abstract

Objectives: To identify patients at risk for coronary artery disease (CAD) through a search of a community pharmacy's prescription database, to screen and identify patients with elevated cholesterol and at risk for CAD, to enroll patients in a pharmacist-directed lipid management program, and to evaluate selected clinical and humanistic outcomes.

Design: Randomized, pretest-posttest control groups.

Setting: Independent community pharmacy in a suburban metropolitan area.

Patients: 51 patients who were not at National Cholesterol Education Program low-density lipoprotein cholesterol (LDL-C) or defined triglyceride goals and who met inclusion criteria.

Intervention: Pharmacist-directed lipid management program.

Main outcome measures: Clinical outcome measures included total cholesterol, LDL-C, high-density lipoprotein cholesterol (HDL-C), and triglyceride levels; achievement of LDL-C goal; and risk factor prediction scores. Humanistic outcome measures included patient satisfaction with pharmaceutical care and patient knowledge of hyperlipidemia.

Results: LDL-C was decreased in the pharmacist intervention group (n = 25), compared with an increase in the control group at study end. HDL-C levels increased and triglyceride levels decreased in both groups. Of treatment group patients, 32% achieved their cholesterol goals, compared with 15% of control group patients. Risk factor prediction scores improved in the treatment group and worsened in the control group. The treatment group's hyperlipidemia knowledge scores improved significantly from pretest to posttest. Both treatment and control group patient satisfaction scores for the pharmacist investigator were favorable at study end.

Conclusion: Both treatment and control patients benefited from participating in this study. Patients enrolled in the lipid management program made greater improvements in their knowledge of hyperlipidemia, risk factor scores, and cholesterol levels.