Community pharmacist assessment of 10-year risk of coronary heart disease for union workers and their dependents.
OBJECTIVE
To determine 10-year coronary heart disease (CHD) risk for union workers and their dependents in a pharmacist-managed health screening program.


METHODS
Two local unions of plumbers and electricians contracted with a community pharmacy to provide health screening services for union workers and their dependents. Patients chose any one or any combination of three clinical tests: blood pressure, total cholesterol, and HDL cholesterol. At the end of the screening, which took approximately 35 minutes, the participants received brief patient education from pharmacists and a printout of their results. Pharmacists provided the services based on their in-store screening experience and, before the screening, received training on 10-year CHD risk calculation and guidelines regarding cholesterol treatment. Framingham scoring was applied to calculate 10-year CHD risk for participants who chose all three clinical tests.


RESULTS
265 patients (55.8% men, average age 57.7 years) participated in the screening program. Frequency of cardiovascular disease (CVD) risk factors ranged from 25.5% (diastolic blood pressure) to 52.5% (total cholesterol). Using Framingham scoring, 10-year CHD risk was calculated for 226 patients, with 119 (52.7%) patients having less than 10% risk with zero to one CVD risk factor, 73 (32.3%) having 10% to 20% risk with two or more CVD risk factors, and 34 (15%) having greater than 20% risk with two or more risk factors.


CONCLUSIONS
Pharmacists provided intermediate- and high-risk participants with guideline-based recommendations such as referring them to physicians for further assessment, therapeutic lifestyle changes, and medication treatment. Community pharmacists were able to identify individuals with intermediate or high 10-year CHD risk. Based on 10-year CHD risk assessment, further pharmacist-managed interventions, such as a cardiovascular risk management program, can be conducted.
Liu
Yifei
Y
Program of Pharmaceutical Socioeconomics, College of Pharmacy, University of Iowa, Iowa City 52242, USA.
Mentele
Leslie J
LJ
McDonough
Randal P
RP
Carruthers
Kara M
KM
Doucette
William R
WR
D000368:Aged; D001794:Blood Pressure; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D003157:Community Pharmacy Services / Q000458:organization & administration*; D003327:Coronary Disease / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D007750:Labor Unions; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010353:Patient Education as Topic; D010595:Pharmacists / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D024382:Professional Role; D012307:Risk Factors
D008076:Cholesterol, HDL; D002784:Cholesterol