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DYSLIPIDEMIA

Evaluation of a Pharmacist-Managed Telephone Lipid Clinic at a Veterans Affairs Medical Center

PGY1 Pharmacy Resident, Department of Veterans Affairs Medical Center, Erie, PA; now, Assistant Professor of Pharmacy Practice, Arnold and Marie Schwartz College of Pharmacy and Allied Health Sciences, Long Island University, Brooklyn, NY

Matthew Bradley, PharmD BCPS

Clinical Pharmacy Specialist, Department of Veterans Affairs Medical Center, Erie; now, Clinical Pharmacy Specialist, Department of Veterans Affairs Medical Center, Cincinnati, OH

Margaret Chrymko, PharmD FASHP

Clinical Pharmacy Specialist, Department of Veterans Affairs Medical Center, Erie

Reprints: Dr. Fabbio, Arnold and Marie Schwartz College of Pharmacy and Allied Health Sciences, Long Island University, 75 Dekalb Ave., Brooklyn, NY 11201, fax 718/780-4056, Kristin.Fabbio{at}liu.edu

BACKGROUND: Heart disease is one of the leading causes of death and disability in the US, with dyslipidemia being a significant risk factor. Pharmacist-managed lipid clinics have been shown to be effective in lowering low-density lipoprotein cholesterol (LDL-C) values in the veteran population. In addition, telephone-managed clinics are known to be an effective method to manage anticoagulation therapy. This type of appointment is very convenient; it reduces travel and waiting times, costs, and potential no-show rates.

OBJECTIVE: To assess changes in LDL-C levels from baseline to follow-up and number of patients attaining LDL-C goals during enrollment in the pharmacist-managed telephone lipid clinic (PMTLC).

METHODS: A retrospective chart review was conducted on all patients enrolled in the clinic who had follow-up laboratory data available. Baseline LDL-C values were compared with values obtained at follow-up. Patients' total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) values were also collected and analyzed for improvement. The agents used, number of antidyslipidemic medications, and the incidence of adverse drug reactions prior to and during clinic enrollment were also collected.

RESULTS: Patients in the PMTLC had a mean ± SD reduction in LDL-C of 44.3 ± 45.2 mg/dL (p < 0.001). In addition, 10 (28%) patients achieved the LDL-C goal (p = 0.002). Mean reductions in TC and TG levels were 44 mg/dL (18%) and 14.6 mg/dL (8%), respectively. There was no significant change in HDL-C levels.

CONCLUSIONS: The PMTLC at the Erie, PA, Veterans Affairs Medical Center demonstrated statistically significant reduction in patients' LDL-C levels and increase in the number of patients attaining LDL-C goal.

Key Words: dyslipidemia, HMG-CoA (hydroxymethylglutaryl coenzyme A) reductase inhibitors, hyperlipidemia, pharmacist, pharmacist managed clinic, statins, telephone

Published Online, December 22, 2009. www.theannals.com, DOI 10.1345/aph.1M276