AJMC: e-Reminder helps discharged patients manage LDL-C

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Low-density lipoprotein cholesterol (LDL-C) and blood pressure measures can remain controlled in most patients discharged from a cardiac disease management program, according to a randomized study in August’s American Journal of Managed Care.

Kari L. Olson, PharmD, from the pharmacy department at University of Colorado, Denver, and colleagues sought to evaluate whether patients with coronary artery disease (CAD) discharged from the Clinical Pharmacy Cardiac Risk Service (CPCRS) would maintain their lipid goals with use of an electronic laboratory reminder system.

Patients with prior CAD (acute MI, CABG or PCI) who had been enrolled in the CPCRS for at least one year and who had two consecutive LDL-C, non-high-density lipoprotein cholesterol (HDL-C) and blood pressure readings at goal within six months before enrollment were randomized to remain in the CPCRS or to receive usual care from primary care physicians plus laboratory reminder letters, the researchers wrote.

The authors said that the primary outcome was maintenance of LDL-C goal at study end.

Olson and colleagues randomized 421 patients (214 CPCRS care, 207 usual care). The mean age was 72 years; 74 percent were male.

After 1.7 years of follow-up, the researchers said that the proportions of patients maintaining their LDL-C goal of less than 100 mg/dL were 91 percent and 93.1 percent in the CPCRS care and usual care groups, respectively (P = .46), the investigators reported. The proportions maintaining their LDL-C goal of less than 70 mg/dL were 68.6 percent and 56.8 percent in the CPCRS care and usual care groups, respectively (P = .23).

Also, Olson and colleagues found there were no differences in the rates of recurrent coronary events and deaths at study end, although the study was not powered to evaluate these differences.

The study was funded by the American College of Clinical Pharmacy Research Institute’s Frontiers Fund.