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Clinical and Economic Impact of Ambulatory Care Clinical Pharmacists in Management of Dyslipidemia in Older Adults: The IMPROVE Study
Author(s) -
Ellis Samuel L.,
Carter Barry L.,
Malone Daniel C.,
Billups Sarah J.,
Okano Gary J.,
Valuck Robert J.,
Barnette Debra J.,
Sintek Charles D.,
Covey Douglas,
Mason Barbara,
Jue Sandra,
Carmichael Jannet,
Guthrie Kelly,
Dombrowski Robert,
Geraets Douglas R.,
Amato Mary
Publication year - 2000
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.20.19.1508.34852
Subject(s) - dyslipidemia , medicine , clinical pharmacy , veterans affairs , ambulatory , ambulatory care , psychological intervention , clinical trial , randomized controlled trial , pharmaceutical care , intervention (counseling) , pharmacist , national cholesterol education program , physical therapy , pharmacy , health care , family medicine , nursing , metabolic syndrome , economics , obesity , economic growth
We examined the impact of ambulatory care clinical pharmacist interventions on clinical and economic outcomes of 208 patients with dyslipidemia and 229 controls treated at nine Veterans Affairs medical centers. This was a randomized, controlled trial involving patients at high risk of drug‐related problems. Only those with dyslipidemia are reported here. In addition to usual medical care, clinical pharmacists were responsible for providing pharmaceutical care for patients in the intervention group. The control group did not receive pharmaceutical care. Seventy‐two percent of the intervention group and 70% of controls required secondary prevention according to the National Cholesterol Education Program guidelines. Significantly more patients in the intervention group had a fasting lipid profile compared with controls (p=0.021). The absolute change in total cholesterol (17.7 vs 7.4 mg/dl, p=0.028) and low‐density lipoprotein (23.4 vs 12.8 mg/dl, p=0.042) was greater in the intervention than in the control group. There were no differences in patients achieving goal lipid values or in overall costs despite increased visits to pharmacists. Ambulatory care clinical pharmacists can significantly improve dyslipidemia in a practice setting designed to manage many medical and drug‐related problems.