BACKGROUND: Previous pharmacist interventions to reduce cardiovascular (CV) risk have been limited by low patient enrolment. The primary aim of this study was to implement a collaborative pharmacist intervention that used a systematic case-finding procedure to identify and manage patients with uncontrolled CV risk factors. METHODS: This was an uncontrolled, program implementation study. We implemented a collaborative pharmacist intervention in a primary care clinic. All adults presenting for an appointment with a participating physician were systematically screened and assessed for CV risk factor control by the pharmacist. Recommendations for risk factor management were communicated on a standardized form, and the level of pharmacist follow-up was determined on a case-by-case basis. We recorded the proportion of adults exhibiting a moderate to high Framingham risk score and at least 1 uncontrolled risk factor. In addition, we assessed before-after changes in CV risk factors. RESULTS: Of the 566 patients who were screened prior to visiting a participating physician, 186 (32.9%) exhibited moderate or high CV risk along with at least 1 uncontrolled risk factor. Physicians requested pharmacist follow-up for 60.8% (113/186) of these patients. Of the patients receiving the pharmacist intervention, 65.5% (74/113) were at least 50% closer to 1 or more of their risk factor targets by the end of the study period. Significant risk factor improvements from baseline were also observed. DISCUSSION: Through implementation of a systematic case-finding approach that was carried out by the pharmacist on behalf of the clinic team, a large number of patients with uncontrolled risk factors were identified, assessed and managed with a collaborative intervention. CONCLUSION: Systematic case finding appears to be an important part of a successful intervention to identify and manage individuals exhibiting uncontrolled CV risk factors in a primary care setting.
BACKGROUND: Previous pharmacist interventions to reduce cardiovascular (CV) risk have been limited by low patient enrolment. The primary aim of this study was to implement a collaborative pharmacist intervention that used a systematic case-finding procedure to identify and manage patients with uncontrolled CV risk factors. METHODS: This was an uncontrolled, program implementation study. We implemented a collaborative pharmacist intervention in a primary care clinic. All adults presenting for an appointment with a participating physician were systematically screened and assessed for CV risk factor control by the pharmacist. Recommendations for risk factor management were communicated on a standardized form, and the level of pharmacist follow-up was determined on a case-by-case basis. We recorded the proportion of adults exhibiting a moderate to high Framingham risk score and at least 1 uncontrolled risk factor. In addition, we assessed before-after changes in CV risk factors. RESULTS: Of the 566 patients who were screened prior to visiting a participating physician, 186 (32.9%) exhibited moderate or high CV risk along with at least 1 uncontrolled risk factor. Physicians requested pharmacist follow-up for 60.8% (113/186) of these patients. Of the patients receiving the pharmacist intervention, 65.5% (74/113) were at least 50% closer to 1 or more of their risk factor targets by the end of the study period. Significant risk factor improvements from baseline were also observed. DISCUSSION: Through implementation of a systematic case-finding approach that was carried out by the pharmacist on behalf of the clinic team, a large number of patients with uncontrolled risk factors were identified, assessed and managed with a collaborative intervention. CONCLUSION: Systematic case finding appears to be an important part of a successful intervention to identify and manage individuals exhibiting uncontrolled CV risk factors in a primary care setting.
Authors: Russell L Rothman; Robb Malone; Betsy Bryant; Ayumi K Shintani; Britton Crigler; Darren A Dewalt; Robert S Dittus; Morris Weinberger; Michael P Pignone Journal: Am J Med Date: 2005-03 Impact factor: 4.965
Authors: Jacques Genest; Ruth McPherson; Jiri Frohlich; Todd Anderson; Norm Campbell; André Carpentier; Patrick Couture; Robert Dufour; George Fodor; Gordon A Francis; Steven Grover; Milan Gupta; Robert A Hegele; David C Lau; Lawrence Leiter; Gary F Lewis; Eva Lonn; G B John Mancini; Dominic Ng; Glen J Pearson; Allan Sniderman; James A Stone; Ehud Ur Journal: Can J Cardiol Date: 2009-10 Impact factor: 5.223
Authors: Douglas S Lee; Maria Chiu; Douglas G Manuel; Karen Tu; Xuesong Wang; Peter C Austin; Michelle Y Mattern; Tezeta F Mitiku; Lawrence W Svenson; Wayne Putnam; William M Flanagan; Jack V Tu Journal: CMAJ Date: 2009-07-20 Impact factor: 8.262