A randomized trial of the effect of community pharmacist intervention on cholesterol risk management: the Study of Cardiovascular Risk Intervention by Pharmacists (SCRIP).
BACKGROUND
Despite clear evidence for the efficacy of lowering cholesterol levels, there is a deficiency in its real-world application. There is a need to explore alternative strategies to address this important public health problem. This study aimed to determine the effect of a program of community pharmacist intervention on the process of cholesterol risk management in patients at high risk for cardiovascular events.


METHODS
A randomized controlled trial conducted in 54 community pharmacies (1998-2000) included patients at high risk for cardiovascular events (with atherosclerotic disease or diabetes mellitus with another risk factor). Patients randomized to pharmacist intervention received education and a brochure on risk factors, point-of-care cholesterol measurement, referral to their physician, and regular follow-up for 16 weeks. Pharmacists faxed a simple form to the primary care physician identifying risk factors and any suggestions. Usual care patients received the same brochure and general advice only, with minimal follow-up. The primary end point was a composite of performance of a fasting cholesterol panel by the physician or addition or increase in dose of cholesterol-lowering medication.


RESULTS
The external monitoring committee recommended early study termination owing to benefit. Of the 675 patients enrolled, approximately 40% were women, and the average age was 64 years. The primary end point was reached in 57% of intervention patients vs 31% in usual care (odds ratio, 3.0; 95% confidence interval, 2.2-4.1; P<.001).


CONCLUSIONS
A community-based intervention program improved the process of cholesterol management in high-risk patients. This program demonstrates the value of community pharmacists working in collaboration with patients and physicians.
Tsuyuki
Ross T
RT
Epidemiology Coordinating and Research (EPICORE) Centre, Division of Cardiology, University of Alberta, 213 Heritage Medical Research Centre, Edmonton, Alberta, Canada T6G 2S2. ross.tsuyuki@ualberta.ca
Johnson
Jeffrey A
JA
Teo
Koon K
KK
Simpson
Scot H
SH
Ackman
Margaret L
ML
Biggs
Rosemarie S
RS
Cave
Andrew
A
Chang
Wei-Ching
WC
Dzavik
Vladimir
V
Farris
Karen B
KB
Galvin
Donna
D
Semchuk
William
W
Taylor
Jeff G
JG
D000416:Alberta; D000704:Analysis of Variance; D002784:Cholesterol / Q000097:blood; D003157:Community Pharmacy Services; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000517:prevention & control*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010174:Pamphlets; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D012017:Referral and Consultation; D012525:Saskatchewan
D002784:Cholesterol