A pharmacy-based approach to cholesterol management.
OBJECTIVE
To determine the clinical and economic impact of a pharmacy-based cholesterol management program in patients with cardiovascular disease.


METHODS
Demonstration project.


METHODS
From January 1, 1999, through June 30, 1999, 300 patients with a documented history of cardiovascular disease were enrolled in a pharmacy-based cholesterol program. A similar group of 150 randomly selected patients receiving usual care during the same period served as the comparator group. The following were collected for both groups: patient demographics, comorbidities, fasting lipid profiles, cholesterol medication, cost of medication, and cardiovascular events. The McNemar symmetry chi2 test was used to compare appropriate laboratory monitoring, receipt of cholesterol medication, and achievement of target low-density lipoprotein cholesterol levels at baseline and 1 year for both groups. Kruskal-Wallis analysis of variance was used to compare the cost of therapy for both groups at baseline and follow-up.


RESULTS
Mean +/- SD age of program and usual care patients was 67 +/- 10 and 69 +/- 11 years, respectively. At 1 year, >95% of program patients were receiving appropriate laboratory monitoring. In 1 year, the percentage of patients reaching target low-density lipoprotein cholesterol levels increased from 45% to 72% (P< .01) and from 33% to 43% (P = .26) in program and usual care patients, respectively. Despite increased medication use among program patients, their cost per patient per month was lower at 1-year follow-up vs baseline.


CONCLUSIONS
Regular patient interaction and close patient monitoring allowed the pharmacy-based lipid management program to improve cholesterol management in patients with cardiovascular disease.
Ditusa
L
L
Department of Pharmacy Practice, University at Buffalo, NY, USA. lditusa@mcp.edu
Luzier
A B
AB
Brady
P G
PG
Reinhardt
R M
RM
Snyder
B D
BD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000924:Anticholesteremic Agents / Q000191:economics / Q000627:therapeutic use*; D019090:Case Management; D008078:Cholesterol, LDL / Q000097:blood; D019468:Disease Management; D016527:Drug Costs; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009518:New York; D010594:Pharmacies / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D016730:Program Development
D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL