Implementation of Pharmaceutical Care Services for Patients with Hyperlipidemias by Independent Community Pharmacy Practitioners Impact of a Pharmaceutical Care Program in a Community Pharmacy on Patients with Dyslipidemia A Pharmacist Care Program Greater effect of enhanced pharmacist care on cholesterol management in patients with diabetes mellitus: a planned subgroup analysis of the Study of Cardiovascular Risk Intervention by Pharmacists (SCRIP). Clinical and economic impact of ambulatory care clinical pharmacists in management of dyslipidemia in older adults: the IMPROVE study. Impact of Managed Pharmaceutical Care on Resource Utilization and Outcomes in Veterans Affairs Medical Centers. Impact of pharmacist-conducted home visits on the outcomes of lipid-lowering drug therapy. Pharmacy- and community-based screenings for diabetes and cardiovascular conditions in high-risk individuals. Pharmacist intervention in the prevention of heart failure for high-risk elderly patients in the community Impact of clinical pharmacists intervention on management of hyperglycemia in pregnancy in Jordan The Effectiveness of Pharmacist Interventions on Cardiovascular Risk: The Multicenter Randomized Controlled RxEACH Trial. Clinical and humanistic outcomes of a lipid management program in the community pharmacy setting. Multifactorial primary prevention of cardiovascular diseases in middle-aged men. Risk factor changes, incidence, and mortality. Effect of a Pharmacist-Led Program on Improving Outcomes in Patients with Type 2 Diabetes Mellitus from Northern Cyprus: A Randomized Controlled Trial. Pharmacist intervention in improving hypertension-related knowledge, treatment medication adherence and health-related quality of life: a non-clinical randomized controlled trial. Effect of pharmaceutical care on clinical outcomes of outpatients with type 2 diabetes mellitus Pharmacist Assisted Medication Program Enhancing the Regulation of Diabetes (PAMPERED) study. Study of Cardiovascular Risk Intervention by Pharmacists (SCRIP): A Randomized Trial Design of the Effect of a Community Pharmacist Intervention Program on Serum Cholesterol Risk
OBJECTIVE : To implement and evaluate pharmaceutical care services for patients with hyperlipidemias in the community pharmacy setting , to evaluate the results of a pharmaceutical care training process for pharmacists by using an assessment quiz , and to measure patient outcomes result ing from provision of pharmaceutical care to patients with hyperlipidemia . DESIGN : A prospect i ve study was conducted over a 1 -year period . Patients served as their own controls . SETTING : Two independent community pharmacies in Richmond , Virginia . PARTICIPANTS : Twenty-five adult patients with confirmed dyslipidemias completed the study . INTERVENTIONS : Study pharmacists assessed each patient and assisted in setting therapeutic goals ; patients also completed a visit with a registered dietitian . Drug therapy recommendations were made to physicians by the pharmacist when appropriate . Follow-up was scheduled with the pharmacist to ensure positive outcomes and reduce adverse effects . MAIN OUTCOME MEASURES : Fasting lipoprotein profiles were measured initially and at 6 and 12 months . The SF-36 survey , the MacKeigan-Larson satisfaction survey , and a patient opinion survey were administered initially and at the conclusion of the study . RESULTS : Total cholesterol and low-density lipoprotein cholesterol values were significantly decreased at 12 months compared with either the baseline or 6-month values ( p < 0.02 ) . Significant improvement was found in several domains of the surveys ; quality of life , patient satisfaction with pharmacy services , and patient opinions on the role of the pharmacist improved after the intervention . CONCLUSIONS : Pharmaceutical care may positively affect lipid values , quality of life , and patient satisfaction BACKGROUND : Inappropriate use of medications is a significant problem in health care today . A possible solution to this problem may be achieved through better control of patients ' drug therapy . OBJECTIVE : To design a pharmaceutical care program for dyslipidemic patients within a community pharmacy setting that provides education in the areas of medication compliance and lifestyle modifications , while emphasizing the importance of achieving cholesterol goals to ensure improvement in quality of life . METHODS : Patients at an outpatient pharmacy volunteered to be surveyed for 16 weeks . Although both the intervention and control groups were surveyed , the r and omly selected intervention group was interviewed more frequently and more comprehensively . Cholesterol , triglycerides , glucose , weight , risk factors , drug-related problems ( DRPs ) , and quality of life were measured via a survey at the onset of the study and continually measured until the study 's conclusion . RESULTS : In the intervention group , 26 DRPs were detected , of which 24 were resolved ; in the control group , 26 DRPs were detected , of which 5 were resolved . When comparing initial and final blood cholesterol levels in the intervention group , the mean decrease was 27.0 ± 41.1 mg/dL ( p = 0.0266 ) ; in the control group , the average blood cholesterol level decreased by a mean of 1.4 ± 37.2 mg/dL ( p = 0.6624 ) . In the intervention group , the triglyceride level decreased an average of 50.5 ± 80.3 mg/dL ( p = 0.0169 ) , while the control group experienced a mean triglyceride level increase of 29.6 ± 118.5 mg/dL ( p = 0.1435 ) . As a result of the intervention , the quality of life in the intervention group was improved . CONCLUSIONS : Short-term pharmaceutical care plans developed in a retail pharmacy within the proper setting may contribute to improved blood lipid values , cardiovascular disease risk factors , and patients ' quality of life Objective : To investigate the effect of a pharmacist care program on cardiovascular risks in type 2 diabetic patients . Methods : A 9-month , prospect i ve , r and omized , controlled study was conducted in a public hospital in Hong Kong . Patients in the intervention group had regular drug-counseling sessions with pharmacists in addition to routine medical care , whereas patients in the control group received only routine medical care . The primary outcome was the change in coronary heart disease ( CHD ) risk . Results : A total of 105 patients completed the study . Patients in the intervention group had a statistically significant reduction in CHD risk compared to those in the control group ( −1.64 % ± 3.56 % ; n = 51 vs −0.01 % ± 3.08 % ; n = 54 , P = .013 ) . For stroke , a reduction in risk was noted in the intervention group , while an increased risk was noted in the control group ( −1.06 % ± 1.82 % vs 0.31 % ± 2.51 % , P = .002 ) . In addition , hemoglobin A1c levels were significantly reduced in the intervention group compared with the control group ( −1.57 % ± 1.50 % vs –0.40 % ± 1.19 % , P < .001 ) ; a similar profile was seen with low-density lipoprotein cholesterol ( −0.36 ± 0.76 vs −0.03 ± 0.74 , P = .026 ) . Furthermore , there were nonsignificant improvements in high-density lipoprotein cholesterol , triglyceride , and blood pressure in the intervention group . The increased level of underst and ing regarding medications in the intervention group was statistically significant ( P < .001 ) , yielding a better enhancement in compliance compared with patients in the control group ( 22.5 % ± 13.4 % vs 2.0 % ± 5.0 % , P < .001 ) . Conclusion : The pharmacist care program implemented in this study demonstrated a significant cardiovascular risk reduction in type 2 diabetic patients ; therefore such a program would be a valuable addition to a multidisciplinary care of diabetic patients STUDY OBJECTIVE To determine the effect of enhanced pharmacist care on cholesterol management in patients with and without diabetes mellitus . METHODS We conducted a planned subgroup analysis of the Study of Cardiovascular Risk Intervention by Pharmacists ( SCRIP ) , a 54-center r and omized trial of pharmacist intervention compared with usual care in patients at high risk for cardiovascular events . The patients involved had atherosclerotic disease or diabetes . We compared the effect of pharmacist intervention in patients with and without diabetes . The primary end point was a composite of performing a fasting cholesterol profile , or adding or increasing the dosage of a cholesterol-lowering drug . Secondary end points were individual components of the primary end point and change in 10-year risk for cardiovascular events , using the Framingham risk equation . RESULTS Of the 675 patients enrolled in the SCRIP study , 294 ( 44 % ) had diabetes .  Enhanced pharmacist care had a more beneficial effect on cholesterol management in those with diabetes ( odds ratio [ OR ] 4.8 ) than without diabetes ( OR 2.1 ) , p=0.01 . Secondary end points showed similar trends , and reduction in Framingham risk was greater in patients with diabetes than without . CONCLUSION Pharmacist intervention for dyslipidemia appears to have a greater impact in patients with diabetes . Results of this sub study suggest that pharmacists should target this patient group for interventions in cholesterol risk management We examined the impact of ambulatory care clinical pharmacist interventions on clinical and economic outcomes of 208 patients with dyslipidemia and 229 controls treated at nine Veterans Affairs medical centers . This was a r and omized , controlled trial involving patients at high risk of drug-related problems . Only those with dyslipidemia are reported here . In addition to usual medical care , clinical pharmacists were responsible for providing pharmaceutical care for patients in the intervention group . The control group did not receive pharmaceutical care . Seventy-two percent of the intervention group and 70 % of controls required secondary prevention according to the National Cholesterol Education Program guidelines . Significantly more patients in the intervention group had a fasting lipid profile compared with controls ( p=0.021 ) . The absolute change in total cholesterol ( 17.7 vs 7.4 mg/dl , p=0.028 ) and low-density lipoprotein ( 23.4 vs 12.8 mg/dl , p=0.042 ) was greater in the intervention than in the control group . There were no differences in patients achieving goal lipid values or in overall costs despite increased visits to pharmacists . Ambulatory care clinical pharmacists can significantly improve dyslipidemia in a practice setting design ed to manage many medical and drug-related problems OBJECTIVE To evaluate a pharmacist-conducted educational and monitoring programme , design ed to promote dietary and lifestyle modification and compliance with lipid-lowering drug therapy , for patients with dyslipidaemia . METHODS This was a prospect i ve , r and omized , controlled study . The participants were 94 adults , with 81 completing the study ( intervention group : 39 ; control group : 42 ) , with a cardiovascular-related diagnosis and discharged from hospital , between April and October 2001 , on lipid-lowering drug therapy .  Patients in the intervention group were visited at home monthly by a pharmacist , who educated the patients on the goals of lipid-lowering treatment and the importance of lifestyle issues in dyslipidaemia and compliance with therapy , assessed patients for drug-related problems , and measured total blood cholesterol levels using point-of-care testing . Patients in the control group received st and ard medical care . The main outcome measure was total blood cholesterol levels after 6 months , and an evaluation of patient and general practitioner satisfaction with the programme . RESULTS There was no significant difference in baseline total blood cholesterol levels between the two groups . The reduction over the course of the study in cholesterol levels within the intervention group was statistically significant ( 4.9 + /- 0.7 to 4.4 + /- 0.6 , P<0.005 ) , whereas there was no change within the control group ( P=0.26 ) . At follow-up , 44 % of the intervention group patients and 24 % of the control group patients had cholesterol levels below 4.0 mmol/L ( P=0.06 ) . The reduction in total cholesterol in the intervention group should translate to an expected 21 % reduction in cardiovascular mortality risk and a 16 % reduction in total mortality risk -- more than twice the risk reduction achieved in the control group . In addition , the programme was very well received by the patients and their general practitioners , by satisfaction question naire . CONCLUSION A pharmacist-conducted educational and monitoring intervention improved the outcomes of lipid-lowering drug therapy OBJECTIVE To assess a model to screen minority , elderly , and at-risk individuals for diabetes , hypertension , and dyslipidemia in pharmacy and non-health care setting s. DESIGN Multicenter , prospect i ve , observational trial . SETTING 26 pharmacies and 4 non-health care setting s. PARTICIPANTS 888 individuals with one or more of the following risk factors : first-degree relative with diabetes , age 55 years or older , obesity , previous diagnosis of hypertension , or a previous diagnosis of dyslipidemia . INTERVENTION  Measurement of plasma glucose , total cholesterol , high-density lipoprotein cholesterol ( HDL-C ) , and blood pressure ; risk assessment using a risk factor tool ; referral of participants with abnormalities to physicians . MAIN OUTCOME MEASURES Adherence with follow-up , physician recommendations , and new diagnoses of diabetes , hypertension , and dyslipidemia . RESULTS Pharmacists screened 888 participants in pharmacies and non-health care setting s ; 794 scored at least 10 on the risk factor tool and received further screenings . Of these , 81 % were referred for follow-up for at least one abnormality : 15 % glucose , 68 % blood pressure , 66 % total cholesterol , and 26 % HDL-C. For those referred , the mean ( + /- SD ) fasting plasma glucose concentration was 179 + /- 87 mg/dL , and the r and om glucose concentration was 234 + /- 90 mg/dL. Of participants completing follow-up , 16 % received one or more new diagnoses as follows : diabetes , 8 ; hypertension , 9 ; and dyslipidemia , 29 . Therapy changed for 42 % of participants . Participants who were elderly , of African American and Hispanic race/ethnicity , or those with elevated cholesterol values were at significantly greater risk for elevated glucose levels . Screenings in community pharmacy setting s had improved follow-up rates with physicians compared with screenings conducted in non-health care setting s. CONCLUSION Pharmacists identified individuals with elevated glucose , cholesterol , and blood pressure values through community-based screenings . Pharmacists also identified individuals who could benefit from further control of previously diagnosed hypertension and hyperlipidemia Background Heart failure has become one of the major causes of hospitalization worldwide . Hypertension , diabetes mellitus and hyperlipidemia are the major causes of heart failure . In order to effectively prevent heart failure , blood pressure , blood glucose and cholesterol levels shall be closely monitored and controlled as well as medication adherence . This study aim ed to investigate the role of pharmacist intervention in prevention of heart failure in high risk elderly patients in the community of Hong Kong . Aim This study aim ed to investigate the role of pharmacist intervention in prevention of heart failure in highrisk elderly patients in the community of Hong Kong . Methods This prospect i ve uncontrolled study was conducted between July 2012 and April 2013 with two revisits every 3 to 4 months to review elderly patients ’ medication profiles as well as assess their blood pressure ( BP ) , r and om capillary blood glucose ( RCBG ) level , cholesterol levels , signs and symptoms of heart failure and the compliance level . The results collected at the baseline data were analyzed and compared with those collected at the last follow-up visit . Result A significant increase in number of subjects free of symptoms of heart failure ( 31.88 % , p < 0.001 ) was found . For chronic disease management , significant reduction in LDL-cholesterol level ( -0.86 ± 0.56mmol/L , p = 0.038 ) and triglyceride level ( -1.15 ± 1.09mmol/L , p < 0.001 ) was observed in overall participants . Yet , no significant reduction in BP level or RCBG level was observed in overall subjects . Significant reduction in mean Morisky Medication Adherence Score ( -0.54 ± 1.50 , p = 0.005 ) indicated improvement in medication compliance in participants . Conclusion The Pharmacy Outreach service has a significant role in prevention of heart failure , by means of minimizing heart failure symptoms , improving medication compliance and enhancing chronic disease management , particularly cholesterol management in community elderly patients . This study provided a reference for further investigation and evaluation of the role of pharmacists in preventing heart failure in the high-risk community elderly patients Background and objective Hyperglycemia in pregnancy is a risk factor for cardiovascular disease and postpartum ( PP ) diabetes . This study aim ed to assess the impact of the clinical pharmacist-assisted program ( CPAP ) of optimizing drug therapy and intensive education on main management outcome measures of patient knowledge about diabetes , Quality of life ( QoL ) as measured by SF-36 including maternal complications , fasting plasma glucose ( FPG ) control , and HbA1c . Method This is a r and omized controlled study . Pregnant ( 20–28 weeks ) patients with hyperglycemia received CPAP ( n = 51 ) as compared with conventional management  ( n = 34 ) . Patients were then followed up for 6 weeks pp . Results A significant change was shown in the intervention group for diabetes knowledge ( 3.47 % vs. control 2.03 % , P < 0.05 ) and three aspects of health-related QoL. The need for caesarian delivery ( 58.8 % vs. control 35.3 % ) and severe episodes of hypoglycemia ( 0 % vs. control 8.8 % ) were significantly ( P < 0.05 ) reduced in the intervention group . Six weeks PP reduction in HbA1c values was greater in the intervention group ( − 0.54 % vs. control − 0.08 % , P = 0.04 ) with more FPG-controlled patients during pregnancy ( 94 % vs. control 64.7 % ) . Conclusion Clinical pharmacist assisted services in the management of pregnancy hyperglycemia fundamentally and significantly improve knowledge and disease control BACKGROUND Despite the cardiovascular disease ( CVD ) risk associated with hypertension , diabetes , dyslipidemia , and smoking , these risk factors remain poorly identified and controlled . OBJECTIVES The study sought to evaluate the effectiveness of a community pharmacy-based case finding and intervention on cardiovascular risk . METHODS The RxEACH ( Alberta Vascular Risk Reduction Community Pharmacy Project ) study was a r and omized trial conducted in 56 community pharmacies . Participants were recruited by their pharmacist , who enrolled adults at high risk for CVD . Patients were r and omized to usual care ( usual pharmacist care with no specific intervention ) or intervention , comprising a Medication Therapy Management review from their pharmacist and CVD risk assessment and education . Pharmacists prescribed medications and ordered laboratory tests as per their scope of practice to achieve treatment targets . Subjects received monthly follow-up visits for 3 months . The primary outcome was difference in change in estimated CVD risk between groups at 3 months . CVD risk was estimated using the greater of the Framingham , International , or United Kingdom Prospect i ve Diabetes Study risk scores . RESULTS We enrolled 723 patients ( mean 62 years of age ; 58 % male , and 27 % smokers ) . After adjusting for baseline values and center effect , there was a 21 % difference in change in risk for CVD events ( p < 0.001 ) between the intervention and usual care groups . The intervention group had greater improvements in low-density lipoprotein cholesterol ( -0.2 mmol/l ; p < 0.001 ) , systolic blood pressure ( -9.37 mm Hg ; p < 0.001 ) , glycosylated hemoglobin ( -0.92 % ; p < 0.001 ) , and smoking cessation ( 20.2 % ; p = 0.002 ) . CONCLUSIONS The RxEACH study was the first large r and omized trial of CVD risk reduction by community pharmacists , demonstrating a significant reduction in risk for CVD events . Engagement of community pharmacists with an exp and ed scope of practice could have significant public health implication s. ( The Alberta Vascular Risk Reduction Community Pharmacy Project : RxEACH [ RxEACH ] ; NCT01979471 ) OBJECTIVES To identify patients at risk for coronary artery disease ( CAD ) through a search of a community pharmacy 's prescription data base , to screen and identify patients with elevated cholesterol and at risk for CAD , to enroll patients in a pharmacist-directed lipid management program , and to evaluate selected clinical and humanistic outcomes . DESIGN R and omized , pretest-posttest control groups . SETTING Independent community pharmacy in a suburban metropolitan area . PATIENTS 51 patients who were not at National Cholesterol Education Program low-density lipoprotein cholesterol ( LDL-C ) or defined triglyceride goals and who met inclusion criteria . INTERVENTION Pharmacist-directed lipid management program . MAIN OUTCOME MEASURES Clinical outcome measures included total cholesterol , LDL-C , high-density lipoprotein cholesterol ( HDL-C ) , and triglyceride levels ; achievement of LDL-C goal ; and risk factor prediction scores . Humanistic outcome measures included patient satisfaction with pharmaceutical care and patient knowledge of hyperlipidemia . RESULTS LDL-C was decreased in the pharmacist intervention group ( n = 25 ) , compared with an increase in the control group at study end . HDL-C levels increased and triglyceride levels decreased in both groups . Of treatment group patients , 32 % achieved their cholesterol goals , compared with 15 % of control group patients . Risk factor prediction scores improved in the treatment group and worsened in the control group . The treatment group 's hyperlipidemia knowledge scores improved significantly from pretest to posttest . Both treatment and control group patient satisfaction scores for the pharmacist investigator were favorable at study end . CONCLUSION Both treatment and control patients benefited from participating in this study . Patients enrolled in the lipid management program made greater improvements in their knowledge of hyperlipidemia , risk factor scores , and cholesterol levels In a r and omized five-year multifactorial primary prevention trial of vascular diseases , hyperlipidemias , hypertension , smoking , obesity , and abnormal glucose tolerance of the high-risk test group ( n = 612 men ) were treated with dietetic-hygienic measures and hypolipidemic ( mainly probucol and clofibrate ) and antihypertensive ( mainly diuretics and beta-blockers ) agents . A matched high-risk control group ( n = 610 ) and a low-risk control group ( n = 593 ) were not treated . The program markedly improved the risk factor status , yet the five-year coronary incidence tended to be higher in the intervention group than in the control group ( 3.1 % vs 1.5 % ) , while the stroke incidence was significantly reduced ( 1.3 % vs 0 % ) . The coronary events tended to be accumulated in subgroups treated with beta-blocking agents or clofibrate , but there were few in those receiving probucol or diuretics . Thus , the intervention program significantly reduced development of stroke , but the occurrence of cardiac events was not prevented . Possible adverse drug effects off setting the probable benefit of improved risk profile are not excluded BACKGROUND The management of type 2 diabetes mellitus is complex , requiring continuous medical care by health care professionals and considerable self-care efforts by patients . Pharmacist-led care programs have been shown to help patients with diabetes succeed in achieving treatment goals and improving outcomes . Pharmacist-led care is a new health care concept in Northern Cyprus . OBJECTIVE To evaluate the effect of a pharmacist-led care program on glycemic control , determined by hemoglobin A1c ( A1c ) , and secondarily on blood pressure , lipid profile , body mass index ( BMI ) , waist circumference , medication adherence , and self-care activities , for patients with type 2 diabetes over a 12-month period . METHODS This was a prospect i ve , r and omized controlled study conducted in a public hospital 's outpatient diabetes clinic , with 152 patients who had been diagnosed with type 2 diabetes . Of these , 75 patients were in the intervention group , and 77 patients were in the usual care group . The intervention group participated in a pharmacist-led care program with a clinical pharmacist who provided 5 face-to-face educational sessions over a period of 12 months . The main outcome measure was change in A1c , and secondary outcome measures were changes in fasting blood glucose , systolic and diastolic blood pressure , lipid values ( total cholesterol , low-density lipoprotein cholesterol [ LDL-C ] , high-density lipoprotein cholesterol [ HDL-C ] , and serum levels of triglycerides [ TGs ] ) , BMI , waist circumference , self-reported medication adherence ( Morisky-Green test ) , and self-care activities . Changes in outcome measures from baseline to the end of the study were assessed using the Mann-Whitney U-test and Wilcoxon test . RESULTS At the end of the 12-month study period , the intervention patients showed a greater reduction in A1c values than the usual care patients ( -0.74 % vs. -0.04 % ; P < 0.001 ) . Both groups showed significant reductions in fasting blood glucose levels between baseline and the end of 12 months ; the difference between the groups was statistically nonsignificant ( P = 0.410 ) . When comparing the intervention and usual care groups , there was a significant decrease in systolic ( P = 0.01 ) and diastolic blood pressure ( P = 0.04 ) at the end of the trial . No significant differences were found between the groups in LDL-C , HDL-C , or TG values ; however , total cholesterol levels did decrease significantly ( P = 0.063 , 0.331 , 0.896 , and 0.04 , respectively ) . Significant reductions occurred in BMI ( P < 0.001 ) and waist circumference ( P < 0.001 ) , and improvements were observed in self-reported medication adherence and self-care activities in the intervention group . CONCLUSIONS A clinical pharmacist-led care program in a public hospital 's outpatient diabetes clinic was associated with significant improvements in reducing A1c and other secondary outcomes in a 12-month r and omized controlled study . DISCLOSURES This study was conducted as a PhD thesis by Korcegez under the supervision of Sancar for the clinical pharmacy program at Near East University , Health Sciences Institute , Northern Cyprus , and received no external funding . The authors have no potential conflicts of interest to report . Study concept and design were contributed by Korcegez , with assistance from Sancar and Demirkan . Korcegez took the lead in data collection , and data interpretation was performed by Korcegez , along with Sancar and Korcegez . The manuscript was written and revised by Korcegez , along with Sancar , and with assistance from Demirkan OBJECTIVE The study evaluated whether a pharmaceutical care intervention can result in better underst and ing about hypertension , increase medication adherence to antihypertensive therapy and improve overall health-related quality of life . METHODS A non- clinical r and omized control trial was conducted whereby participants received an educational intervention through hospital pharmacists .  Hypertension knowledge , medication adherence and health-related quality of life were measured by means of self-administered question naires . Descriptive statistics were used to describe the demographic and disease characteristics of the patients . Inferential statistics were used for inter- and intragroup comparisons . SPSS 17 was used for data analysis . RESULTS Three hundred and eighty-five hypertensive patients were r and omly assigned ( 192 in the control group and 193 in the intervention group ) to the study . No significant differences were observed in either group for age , gender , income , locality , education , occupation or duration of disease . There was , however , a significant increase in the participants ' levels of knowledge about hypertension and medication adherence among the interventional group after completing the intervention . Significantly lower systolic and diastolic blood pressure levels were also observed among the interventional group after completion of the intervention . The interventional group , however , reported decreased yet significant health-related quality of life at the end of the interventional programme . CONCLUSION Pharmacist intervention can significantly increase disease-related knowledge , blood pressure control and medication adherence in patients with hypertension . However , further research is needed to address the decreased health-related quality of life after completion of the study Background In the People ’s Republic of China , out patients have limited time with their physicians . Thus , compared to in patients , out patients have lower medication adherence and are less knowledgeable about their disease . Objective The objective of this study was to evaluate the effect of pharmaceutical care on clinical outcomes of out patients with type 2 diabetes mellitus ( T2DM ) . Patients and methods A r and omized , controlled , prospect i ve clinical trial was conducted recruiting a total of 240 T2DM out patients from Zhongda Hospital , Southeast University . The control group ( CG ) received only common care from medical staff , whereas the inter vention group ( IG ) received extra pharmaceutical care from clinical pharmacists . Biochemical data such as  blood pressure ( BP ) , fasting blood glucose ( FBG ) , glycosylated hemoglobin A1 ( HbA1c ) , and blood lipid  were collected before and after 6-month intervention . The primary end points in this study were FBG and HbA1c . Results After the intervention , most of the baseline clinical outcomes of the patients in IG significantly improved , while only body mass index , diastolic BP , low-density lipoprotein cholesterol , and total cholesterol ( TC ) improved significantly in patients in the CG . Compared to CG , in IG , there were significant improvements in FBG , HbA1c , TC , the target attainment rates of HbA1c , and BP . Conclusion Pharmaceutical care provided by clinical pharmacists could improve the control of diabetes of out patients , and clinical pharmacists could play an important role in diabetes management OBJECTIVES To demonstrate that pharmacists working with physicians and other providers in an ambulatory care setting can improve glucose , blood pressure , and lipid control for patients with type 2 diabetes and to report patient adherence to screening and general preventive measures . DESIGN Prospect i ve , r and omized , clinical practice study . SETTING Burlington , MA , between January 2001 and August 2003 . PATIENTS 164 patients patients with type 2 diabetes older than 18 years with glycosylated hemoglobin ( A1C ) greater than 8 % . INTERVENTION Pharmacist-patient clinic visits included obtaining a comprehensive medication review ; performing targeted physical assessment ; ordering laboratory tests ; review ing , modifying , and monitoring patients ' medication therapy and providing detailed counseling on all therapies ; facilitating self-monitoring of blood glucose ; and providing reinforcement of dietary guidelines and exercise . MAIN OUTCOME MEASURE Effect of clinical pharmacists working with physicians in an ambulatory setting on health measures ( e.g. , A1C , blood pressure , cholesterol ) of patients with diabetes . RESULTS Baseline characteristics were similar between the two groups . After 1 year , significant improvements occurred for A1C and low-density lipoprotein ( LDL ) cholesterol in the intervention group compared with the control group ( A1C , 7.7 % vs. 8.4 % ; LDL , 93.7 vs. 105.1 mg/dL ; P < 0.05 ) . Systolic blood pressure improved for all study patients without a difference between the two groups . Diastolic blood pressure improved significantly in the intervention group compared with the control group ( 73.4 mm Hg vs. 77.6 mm Hg , P < 0.05 ) . Significantly more intervention patients were screened for retinopathy , neuropathy , and microalbuminuria than control patients ( P < 0.05 ) . CONCLUSION For all indices measured , this study demonstrated that collaborative diabetes management with a clinical pharmacist can improve overall care OBJECTIVE : To determine the efficacy of a program of intervention by pharmacists on lipid risk management in patients at high risk for cardiovascular events . METHODS : R and omized , multicenter ( 44 sites in Alberta and Saskatchewan ) study of community pharmacist intervention versus usual care in 1000 patients . Patients are those at high risk of vascular events ( existing atherosclerotic vascular disease , or diabetes with ≥1 other risk factor ) . After obtaining consent , the pharmacist calls the Project Office to r and omize . Patients allocated to intervention receive a brochure and education about cardiovascular risk factors . Pharmacists also complete a physician contact form , which lists the patient 's risk factors , medications , and any recommendations . A point-of-care cholesterol test is performed , the result is discussed with the patient , and it is entered on the contact form . If appropriate , the patient is asked to see his or her primary care physician for further assessment and /or treatment , and the form is faxed to the physician . Patients are followed up at two , four , eight , 12 , and 16 weeks . During follow-up visits , pharmacists provide educational reinforcement and check for primary end point occurrence . Patients allocated to usual care receive the brochure only , with minimal follow-up . The primary end point is a composite of measurement of a complete lipid panel by the physician , or addition or modification of lipid-lowering drug therapy . Sub studies will evaluate economics ( third-party payer and pharmacy manager perspective ) , patient satisfaction , and quality of life . CONCLUSIONS : SCRIP ( Study of Cardiovascular Risk Intervention by Pharmacists ) is a unique ongoing trial that is evaluating a community pharmacist intervention design ed to optimize cholesterol risk management in patients at high risk for cardiovascular events
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 .