Application of the SCORE and Wilson-Grundy methods for the assessment of cardiovascular risk in community pharmacies.
BACKGROUND
The assessment and follow-up of patients with risk factors, or with cardiovascular disease (CVD), involves estimating and monitoring their CVD risk (CVDR). There are different opinions about the most appropriate method for this.


OBJECTIVE
To compare the SCORE system and the Wilson-Grundy system (based on Framingham's study).


METHODS
A descriptive, observational study over 15 days in six pharmacies, with patients aged between 25 and 74 years, and with a prescription for medications related to hypertension, dyslipidaemia, CVD prevention or type-2 diabetes. Results of patients' absolute CVDR were assessed and compared using the SCORE system and the Wilson-Grundy method, adapted for Spain. The Chi-square test was used to compare proportions, and the Student t-test was used to compare mean values, including odds ratios (OR) and 95% confidence intervals (95%CI).


RESULTS
A total of 257 patients [165 women, 92 men; mean (SD) age, 60.9 (10.8) years; percentage of previous medical history of hypertension (70.0%), dyslipidaemia (42.4%), type-2 diabetes (19.5%) and CVD (22.6%)] participated. With the CVDR assessed with SCORE, the distribution was as follows: low 35.8%, intermediate 21.0% and high 43.2%. The corresponding values using the Wilson-Grundy system was low 60.7%, intermediate 8.2% and high 31.1%.


CONCLUSIONS
The cardiovascular risk of patients that attend community pharmacies with prescriptions for cardiovascular medications is significantly higher when assessed using the SCORE system than with the Wilson-Grundy method.
Department of Pharmacy, Faculty of Pharmaceutical Chemist, University of Antioquia, Medellin, Colombia. pamaris@farmacia.udea.edu.co
P
P
Amariles
M
M
Machuca
M J
MJ
Faus
M I
MI
Baena
F
F
Martinez-Martinez
J
J
Jimenez-Martin
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D016009:Chi-Square Distribution; D003157:Community Pharmacy Services / Q000458:organization & administration*; D016001:Confidence Intervals; D003627:Data Interpretation, Statistical; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy; D050171:Dyslipidemias / Q000150:complications / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D013030:Spain