Pharmacist-directed care or in collaboration with physicians or nurses improve the management of major CVD risk factors in out patients
BACKGROUND Pharmacists may improve the clinical management of major risk factors for cardiovascular disease ( CVD ) prevention .
A systematic review was conducted to determine the impact of pharmacist care on the management of  CVD risk factors among out patients .
Clinical outcomes in managed-care patients with coronary heart disease treated aggressively in lipid-lowering disease management clinics: the alliance study.
OBJECTIVES This study sought to determine if an aggressive , focused low-density lipoprotein cholesterol (LDL-C)-lowering strategy was superior to usual care for coronary heart disease ( CHD ) patients enrolled in health maintenance organization or Veterans Administration setting s. BACKGROUND Statin therapy benefits are well established . No prospect i ve , r and omized studies have tested strategies to optimize these benefits in a " real-world " setting . METHODS A total of 2,442 CHD patients with hyperlipidemia were r and omized to either an aggressive treatment arm using atorvastatin or usual care and followed for 51.5 months on average . Atorvastatin-group patients were titrated to LDL-C goals of < 80 mg/dl ( 2.1 mmol/l ) or a maximum atorvastatin dose of 80 mg/day . Usual-care patients received any treatment deemed appropriate by their regular physicians . End point assessment s were complete in 958 atorvastatin-group and 941 usual-care patients . Partial assessment s occurred in 259 patients in the atorvastatin group and 284 patients in the usual care group who did not complete four years of study participation because of adverse events , withdrawn consent , or follow-up loss . The primary efficacy parameter was time to first cardiovascular event . RESULTS A total of 289 ( 23.7 % ) patients in the atorvastatin group compared with 333 ( 27.7 % ) patients in the usual care group experienced a primary outcome ( hazard ratio , 0.83 ; 95 % confidence interval 0.71 to 0.97 , p = 0.02 ) . This reduction in morbidity was largely due to fewer non-fatal myocardial infa rct ions ( 4.3 % vs. 7.7 % , p = 0.0002 ) . Levels of LDL-C were reduced more ( 34.3 % vs. 23.3 % , p < 0.0001 ) and National Cholesterol Education Program goals ( LDL-C < 100 mg/dl ) more likely met at end-of- study visits ( 72.4 % vs. 40.0 % ) in patients receiving atorvastatin compared with those receiving usual care . CONCLUSIONS An aggressive , focused statin therapy management strategy outperformed usual care in health maintenance organization and Veterans Administration clinic patients with CHD
Pharmacist-directed care or in collaboration with physicians or nurses improve the management of major CVD risk factors in out patients
BACKGROUND Pharmacists may improve the clinical management of major risk factors for cardiovascular disease ( CVD ) prevention .
A systematic review was conducted to determine the impact of pharmacist care on the management of  CVD risk factors among out patients .