Pharmacist care ‘important’ in dyslipidemia management
MedWire News: Results of a systematic review published in Pharmacotherapy suggest that engaging pharmacists in the care of patients with dyslipidemia could have an important effect on public health.
"Pharmacist care improved lipid parameters, notably LDL [low-density lipoprotein] levels, as well as increased the proportion of patients who achieved targeted levels," report Ross Tsuyuki (University of Alberta, Edmonton, Canada) and colleagues.
"These results demonstrate the benefit of pharmacist care across the spectrum of dyslipidemia management, from screening patients to recommending treatment to assisting patients to attain clinical targets," they write.
Pharmacists are the most accessible healthcare professional; they often see their patients more frequently than physicians do, explain Tsuyuki et al. Yet pharmacist-directed disease management programs have not been widely implemented.
To evaluate the effect of pharmacist care on the management of patients with dyslipidemia, the researchers evaluated data from 21 randomized clinical controlled trials, involving more than 5000 patients, which included a pharmacist intervention compared with usual care (control). Duration of the studies ranged from 16 weeks to 2 years, with a median duration of 12 months.
The researchers report that mean LDL cholesterol was 10.7 mg/dL (0.28 mmol/L) lower in the pharmacist care groups compared with the standard care groups at the end of follow-up. Total cholesterol was also significantly lower in the pharmacist care group. However, these results were highly heterogeneous, note the authors.
Patients who received pharmacist care were 2.5 times more likely to attain target lipid levels (determined using guidelines available at the time of the specific study) and 2.1 times more likely to have a lipid panel ordered or recommended by a pharmacist during the study than those receiving standard care.
Patients in the pharmacist intervention groups were also 1.8 times more likely than patients in the standard care groups to have a change in their lipid-lowering therapy (addition of lipid-lowering agents or increase in dose).
"Pharmacist involvement from screening patients right up to initiation of therapy and follow-up is proving to be essential in achieving positive outcomes in patients with cardiovascular risk factors," write the authors.
"Greater involvement of pharmacists with these activities could have an important effect on public health."
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By Nikki Withers