Involving pharmacists in care decisions may reduce risk of cardiovascular disease

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 - Tim Casey
Tim Casey, Executive Editor

For years, healthcare industry leaders have discussed the benefits of physicians, nurses, pharmacists and other healthcare professionals collaborating to better serve patients and reduce costs.

By working together, the thinking goes, they offer patients more comprehensive care, keep them out of hospitals and reduce their reliance on expensive medications and treatments. Still, it’s not always as easy to implement programs in practice as it seems like it would be on paper.

A recent study from Alberta, Canada, though, could serve as a model of how to successfully integrate physicians and pharmacists.

The trial enrolled 723 patients at high risk for cardiovascular events. They were randomized to a group that received medication therapy management review from their pharmacist and cardiovascular disease risk assessment and education or a placebo group. The former group had their blood pressure, waist circumference, and height and weight measured, underwent a laboratory assessment and received an individualized assessment and education protocol as well as treatment recommendations.

After three months and after adjusting for baseline characteristics, the intervention group had a 21 percent decrease in risk for cardiovascular events. The difference was statistically significant.

Patients in the intervention group also had a significant reduction in low-density lipoprotein cholesterol, blood pressure, HbA1c level and smoking status.

“Because pharmacists are highly accessible primary healthcare providers, this could have major public health implications in reducing the burden of [cardiovascular disease] if these practices were widely adopted,” the researchers wrote.

The researchers acknowledged that the trial’s design wasn’t perfect. For instance, they only followed patients for three months. The findings may also not be generalizable to other cities or regions because pharmacists in Alberta can order laboratory tests and have independent prescribing mandates. Still, the researchers said many pharmacists in North American can conduct medication management reviews, adjust medications, consult with physicians and make recommendations.

In the U.S. and Canada, there are 450,000 pharmacists who are willing and able to help combat cardiovascular disease, according to the researchers.

“It is important to note that the reductions in cardiovascular risk were achieved on top of (not instead of) usual physician care,” the researchers wrote. “Interprofessional communication and collaboration remain key. We would encourage policymakers to consider broadening the scope of practice of pharmacists (as in Alberta) and for pharmacists and professional pharmacy organizations to seize these opportunities for the betterment of patient care.”