Pharmacist Intervention in Risk Reduction Study: High-Risk Cardiac Patients

Abstract

Objectives: Although there are guidelines for managing patients at high vascular risk, many people remain undertreated. This community-based study was designed to 1) measure the ability of the pharmacist—physician collaboration to affect a broad array of drug-related endpoints and 2) to compare 2 methods of training community pharmacists to collaborate with physicians on cardiac patient care. This paper focuses on the first outcome, and a companion paper will address the second outcome. Methods: We used a before-and-after design to assess pharmacists' ability to affect drug-related endpoints. We identified patients by various methods, one of which was medication profiles. Those providing consent were educated on risk factor modification and encouraged to consult their physicians. Pharmacists subsequently faxed the details of their assessments to the primary care physician, along with suggestions for therapy changes. Our outcome measure was the proportion of patients who achieved a composite of either a dose increase or a new target medication as a result of pharmacist recommendations during the study. Results: A total of 61 pharmacists recruited 217 patients, and of these, follow-up was completed on 216. Of the patients for whom a pharmacist made a suggestion, pharmacologic risk reduction therapy was initiated or enhanced in 53.7%. Conclusion: This community pharmacist—based program improved utilization of the therapies known to decrease vascular risk in patients considered high risk.