Workplace-based cardiovascular risk management by community pharmacists: impact on blood pressure, lipid levels, and weight.
OBJECTIVE
To assess the effectiveness of a community pharmacist-delivered cardiovascular case-management program by comparing body mass index (weight), systolic and diastolic blood pressure, and full lipid profile at the beginning of the program with these outcome measures at the end of the program.


METHODS
Retrospective data analysis using billing data submitted between July 1, 2001, and October 31, 2004, with a pre-post design in which subjects served as their own controls.


METHODS
Manufacturing workplace in rural Iowa.


METHODS
Fifty-six workers with risk factors for cardiovascular disease (mean age 40.67 yrs), 37 had diabetes mellitus and 19 did not.


METHODS
During visits to the workers, pharmacists provided education about cardiovascular disease, identification of drug therapy problems, and importance of routine blood pressure, pulse, and weight measurements; they communicated with participants' physicians as needed.


RESULTS
The number of pharmacist visits/participant ranged from 1-13 (mean +/- SD 6.97 +/- 3.05). Outcome measures were weight, systolic and diastolic blood pressures, full lipid profiles (in patients with diabetes), and percentage of patients achieving treatment goal by the end of the 3 years. Statistically significant differences between the first and last visits were achieved for both systolic (124.12 +/- 11.07 and 120.36 +/- 14.39 mm Hg, respectively, p=0.016) and diastolic (80.4 +/- 9.01 and 77.43 +/- 9.14 mm Hg, respectively, p=0.019) blood pressure. The 19 patients without diabetes showed a statistically significant improvement in diastolic blood pressure (p=0.039), but the 37 patients with diabetes did not show a significant difference. A nonsignificant increase was seen in the percentage of patients with diabetes achieving low-density lipoprotein cholesterol (LDL) level goal between the first and last visits (p=0.06).


CONCLUSIONS
A cardiovascular case-management program delivered in the workplace to middle-aged working adults by community pharmacists improved blood pressure and reduced LDL levels. The program was not effective, however, in weight reduction.
John
Elizabeth J
EJ
Division of Clinical and Administrative Pharmacy, College of Pharmacy, University of Iowa, Iowa City, Iowa 52242-1112, USA.
Vavra
Theresa
T
Farris
Karen
K
Currie
Jay
J
Doucette
William
W
Button-Neumann
Brenna
B
Osterhaus
Matt
M
Kumbera
Patty
P
Halterman
Tom
T
Bullock
Tammy
T
D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000517:prevention & control*; D019090:Case Management; D048909:Diabetes Complications; D005260:Female; D006266:Health Education; D006801:Humans; D007221:Industry; D007484:Iowa; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009786:Occupational Health Services / Q000458:organization & administration*; D010043:Outcome and Process Assessment, Health Care; D010594:Pharmacies; D010595:Pharmacists; D015397:Program Evaluation; D012189:Retrospective Studies; D012307:Risk Factors; D012308:Risk Management; D019035:Rural Health Services / Q000458:organization & administration*; D017132:Workplace
D008055:Lipids