A clinical ly relevant but not statistically significant reduction in triglycerides was found .
No impact on HDL-C levels was found .
Patients ' adherence to pharmacotherapeutic regimens and quality of life were considered possibly not sensitive and possibly sensitive to pharmacist interventions , respectively .
Total cholesterol is sensitive to pharmacist interventions , while LDL-C and triglyceride levels are possibly sensitive to those interventions .
BACKGROUND Hyperlipidemia increases the risk of cardiovascular diseases , and control is pivotal for preventing disease complications .
Multidisciplinary interventions , including those performed by pharmacists , are important for improving patients ' outcomes .
OBJECTIVE To quantify the impact of pharmacist interventions in enhancing patients ' outcomes .
Lipid levels and use of lipid-lowering drugs for patients in pharmacist-managed lipid clinics versus usual care in 2 VA Medical Centers.
OBJECTIVE The objective of this study was to assess the effectiveness of pharmacist- managed dyslipidemia clinics at 2 Veterans Affairs medical centers since the release of the 2001 National Cholesterol Education Panel Adult Treatment Panel III ( NCEP ATP III ) guideline compared with the usual care ( UC ) provided by other health care professionals in the same setting . METHODS Analysis was performed through retrospective chart review of patients with a diagnosis of dyslipidemia who received care in either the Amarillo or Lubbock , Texas , pharmacist-managed lipid clinics ( LCs ) or UC from a primary care physician . Data from medical charts were abstract ed for date s of service from July 2001 to December 2003 for 115 patients selected r and omly from LC rolls matched with 115 patients with a diagnosis of dyslipidemia selected r and omly from UC . All patients had to have had at least 3 visits with the LC or 3 visits in UC with a billing code of dyslipidemia ; they were followed for at least 6 months after an initial visit in July 2001 or thereafter and were enrolled in the VA health care system for at least 1 year . Baseline lipid values were available for LC but not UC patients . Cholesterol target goals were determined according to NCEP ATP III guideline . RESULTS After an average of 21.6 months of follow-up , the proportion of patients in the LC group that attained goal level increased from 45.2 % at baseline to 82.6 % for total cholesterol ( TC ) and from 36.5 % at baseline to 64.3 % for lowdensity lipoprotein cholesterol ( LDL-C [ P < 0.001 for both comparisons ] ) . There was an average 24.5 mg/dL absolute reduction ( relative reduction , 19.4 % ) in LDL-C along with significant improvements in the other lipid levels ( P < 0.001 for TC and LDL-C , P = 0.007 for triglycerides [ TGs ] ) with the exception of highdensity lipoprotein cholesterol ( HDL-C ) , which declined from 40.0 mg/dL to 36.3 mg/dL ( P < 0.001 ) . A total of 50 patients ( 43.5 % ) were on lipid-lowering pharmacotherapy at baseline versus 108 patients ( 93.9 % ) at follow-up . Compared with UC , LC patients were more likely to have achieved goal LDL-C ( 64.3 % vs. 15.7 % for UC , P < 0.001 ) and TC ( 82.6 % vs. 40.9 % , P < 0.001 ) , but there was no difference in the proportion of patients at TG goal for LC ( 65.2 % ) compared with UC ( 52.2 % , P = 0.061 ) or at HDL-C goal ( 23.5 % for LC vs. 33.0 % for UC , P = 0.143 ) . A higher proportion of LC patients ( 93.9 % ) used  lipid-lowering agents  compared with UC patients ( 24.3 % , P < 0.001 ) . Sub analysis of patients on a lipid-lowering agent found that a significantly higher proportion ( 85.2 % ) in the LC group were at goal total cholesterol compared with 60.7 % for UC ( P = 0.012 ) and at goal LDL-C ( 66.7 % for LC vs. 39.3 % for UC , P = 0.016 ) . However , a lower proportion were at goal HDL-C for LC ( 21.3 % ) versus 42.9 % for UC ( P = 0.043 ) . Overall , only 11 LC patients ( 9.6 % ) attained goal levels for all 4 serum lipid values by the end of follow-up versus 2 UC patients ( 1.7 % , P = 0.019 ) . CONCLUSIONS Nearly two thirds of patients diagnosed with dyslipidemia and enrolled in a pharmacist-managed LC had LDL-C levels at or below NCEP ATP III target goal compared with 16 % of dyslipidemia patients who received UC from their primary care provider . The pharmacist-managed LC patients were also twice as likely ( 83 vs. 41 % ) to have attained the TC target goal , but there was no difference between the 2 groups in the proportion of patients who attained either TG or HDL-C target goals . Only 9.6 % of LC patients were at goal for all 4 individual lipid measures at the end of follow-up
A clinical ly relevant but not statistically significant reduction in triglycerides was found .
No impact on HDL-C levels was found .
Patients ' adherence to pharmacotherapeutic regimens and quality of life were considered possibly not sensitive and possibly sensitive to pharmacist interventions , respectively .
Total cholesterol is sensitive to pharmacist interventions , while LDL-C and triglyceride levels are possibly sensitive to those interventions .
BACKGROUND Hyperlipidemia increases the risk of cardiovascular diseases , and control is pivotal for preventing disease complications .
Multidisciplinary interventions , including those performed by pharmacists , are important for improving patients ' outcomes .
OBJECTIVE To quantify the impact of pharmacist interventions in enhancing patients ' outcomes .