A randomized trial of the effect of community pharmacist intervention on cholesterol risk management: the Study of Cardiovascular Risk Intervention by Pharmacists (SCRIP)

• Published in: Archives of internal medicine (1960) Vol. 162; no. 10; p. 1149
• Main Authors: Tsuyuki, Ross T, Johnson, Jeffrey A, Teo, Koon K, Simpson, Scot H, Ackman, Margaret L, Biggs, Rosemarie S, Cave, Andrew, Chang, Wei-Ching, Dzavik, Vladimir, Farris, Karen B, Galvin, Donna, Semchuk, William, Taylor, Jeff G
• Format: Journal Article
• Language: English
• Published: United States 27.05.2002
• Subjects: Alberta; Analysis of Variance; Cholesterol - blood; Community Pharmacy Services; Female; Humans; Hypercholesterolemia - prevention & control; Male; Mass Screening; Middle Aged; Patient Education as Topic; Patient Satisfaction; Referral and Consultation; Saskatchewan; Alberta; Saskatchewan
• ISSN: 0003-9926
• DOI: 10.1001/archinte.162.10.1149

Despite clear evidence for the efficacy of lowering cholesterol levels, there is a deficiency in its real-world application. There is a need to explore alternative strategies to address this important public health problem. This study aimed to determine the effect of a program of community pharmacist intervention on the process of cholesterol risk management in patients at high risk for cardiovascular events. A randomized controlled trial conducted in 54 community pharmacies (1998-2000) included patients at high risk for cardiovascular events (with atherosclerotic disease or diabetes mellitus with another risk factor). Patients randomized to pharmacist intervention received education and a brochure on risk factors, point-of-care cholesterol measurement, referral to their physician, and regular follow-up for 16 weeks. Pharmacists faxed a simple form to the primary care physician identifying risk factors and any suggestions. Usual care patients received the same brochure and general advice only, with minimal follow-up. The primary end point was a composite of performance of a fasting cholesterol panel by the physician or addition or increase in dose of cholesterol-lowering medication. The external monitoring committee recommended early study termination owing to benefit. Of the 675 patients enrolled, approximately 40% were women, and the average age was 64 years. The primary end point was reached in 57% of intervention patients vs 31% in usual care (odds ratio, 3.0; 95% confidence interval, 2.2-4.1; P<.001). A community-based intervention program improved the process of cholesterol management in high-risk patients. This program demonstrates the value of community pharmacists working in collaboration with patients and physicians.