title: A randomized trial of the effect of community pharmacist intervention on cholesterol risk management: the Study of Cardiovascular Risk Intervention by Pharmacists (SCRIP).
abstract: 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.
authors.affiliation: 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
authors.forename: Ross T
authors.initials: RT
authors.lastname: Tsuyuki
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Johnson
authors.forename: Koon K
authors.initials: KK
authors.lastname: Teo
authors.forename: Scot H
authors.initials: SH
authors.lastname: Simpson
authors.forename: Margaret L
authors.initials: ML
authors.lastname: Ackman
authors.forename: Rosemarie S
authors.initials: RS
authors.lastname: Biggs
authors.forename: Andrew
authors.initials: A
authors.lastname: Cave
authors.forename: Wei-Ching
authors.initials: WC
authors.lastname: Chang
authors.forename: Vladimir
authors.initials: V
authors.lastname: Dzavik
authors.forename: Karen B
authors.initials: KB
authors.lastname: Farris
authors.forename: Donna
authors.initials: D
authors.lastname: Galvin
authors.forename: William
authors.initials: W
authors.lastname: Semchuk
authors.forename: Jeff G
authors.initials: JG
authors.lastname: Taylor
mesh_terms: 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
chemical_list: D002784:Cholesterol