Efficacy of a pharmacist-led cardiovascular risk reduction clinic for diabetic patients with and without mental health conditions.
Coexisting mental health conditions (MHCs) attenuate treatment effects in diabetes. A retrospective analysis was performed of a pharmacist-led cardiovascular risk reduction clinic (CRRC) targeting hypertension, diabetes, hyperlipidemia, and tobacco use in patients with at least one CRRC visit between January 2001 and January 2002. The United Kingdom Prospective Diabetes Study (UKPDS) risk change (after/before CRRC) for those with and without MHCs was compared. Of the 297 with diabetes and complete UKPDS data, 40.7% had at least 1 MHC (22.3% had a severe MHC). Patients with MHCs had a similar number of CRRC visits (4.7+/-2.6 vs 4.4+/-2.6) but had a lower baseline UKPDS score (0.31+/-0.18 vs 0.40+/-0.20; P=.001) compared with non-MHC patients. The risk change after CRRC was similar for those with and without MHCs (0.10+/-0.13 vs 0.10+/-0.14; P=.82), but patients with MHCs had a longer CRRC enrollment (245+/-152 vs 205+/-161 days; P<.03). The efficacy of the CRRC model to reduce cardiovascular risk is not attenuated by a concomitant MHC.
Taveira
Tracey H
TH
Providence Veterans Affairs Medical Center, RI, USA. ttaveira@uri.edu
Pirraglia
Paul A
PA
Cohen
Lisa B
LB
Wu
Wen-Chih
WC
D000368:Aged; D000554:Ambulatory Care Facilities; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D016014:Linear Models; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D010593:Pharmaceutical Services; D011336:Probability; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D040242:Risk Reduction Behavior; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014728:Veterans
D007004:Hypoglycemic Agents; D011619:Psychotropic Drugs