title: Impact of live medication therapy management on cholesterol values in patients with cardiovascular disease.
abstract: OBJECTIVE
  To compare the impact of clinical pharmacist (CP) recommendations through a live, primary care-based, medication therapy management (MTM) protocol on low-density-lipoprotein (LDL) cholesterol in patients who have cardiovascular disease (CVD) with standard, chart-review MTM.
  
  
  METHODS
  Patients with established CVD who were not at their LDL goal were identified and analyzed by either a chart-review MTM service or a live, one-on-one pharmacist-physician MTM service over a 6-month timeframe. For the chart-review MTM service, recommendations were communicated through an electronic medical record (EMR) that the physician and pharmacist had access to.
  
  
  RESULTS
  Primary outcomes included mean LDL reduction from baseline, number of patients achieving their LDL goal, and percent of implemented CP recommendations. Mean LDL reduction from baseline in the chart-review MTM group and the live MTM group was 36 mg/dL ± 23.2 mg/dL (P = 0.001) and 62 mg/dL ± 28.3 mg/dL (P = 0.001), respectively. The difference between these two groups was statistically significant (P = 0.001). The chart-review MTM group had 30% of patients reach their LDL goal with 66.3% of CP recommendations implemented compared to 51.3% and 86.3% for the same parameters in the live MTM group (P = 0.006 and P = 0.003, respectively).
  
  
  CONCLUSIONS
  Although both MTM services provide a significant LDL reduction from baseline in patients with CVD, live MTM provides significantly greater LDL reductions, implemented CP recommendations, and goal attainment than chart-review MTM. Thus, live MTM services are more effective than chart-review MTM services, at least within the clinics that these protocols were assessed for the purposes of this study.
authors.forename: Ricky
authors.initials: R
authors.lastname: Thumar
authors.forename: Kathy
authors.initials: K
authors.lastname: Zaiken
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000188:drug therapy*; D008078:Cholesterol, LDL / Q000097:blood*; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D008297:Male; D054539:Medication Therapy Management / Q000458:organization & administration*; D008875:Middle Aged; D010593:Pharmaceutical Services / Q000458:organization & administration; D010595:Pharmacists / Q000458:organization & administration*; D010865:Pilot Projects; D011320:Primary Health Care / Q000458:organization & administration; D011446:Prospective Studies
chemical_list: D008078:Cholesterol, LDL