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Impact of Pharmacy-led Dyslipidemia Interventions on Medication Safety and Therapeutic Failure in Patients.


In: Henriksen K1, Battles JB1, Marks ES2, Lewin DI1, editors.


Advances in Patient Safety: From Research to Implementation (Volume 1: Research Findings). Rockville (MD): Agency for Healthcare Research and Quality (US); 2005 Feb.
Advances in Patient Safety.

Author information

Agency for Healthcare Research and Quality
US Department of Defense
45th Medical Support Squadron, Patrick Air Force Base, FL (JGW, TL); Pfizer, Inc., Orlando, FL (JEM); Wuesthoff Medical Center, Rockledge, FL (RBM); 1st Medical Support Squadron, Langley Air Force Base, VA (HRS); 17th Medical Support Squadron, Goodfellow Air Force Base, TX (SKH)


Objectives: The researchers sought to assess the impact of pharmacologic intervention on previously identified patients with coronary heart disease (CHD), diabetes, or multiple risk factors who experienced therapeutic failure in treating hyperlipidemia. The study also sought to evaluate changes in medication usage patterns, including rates of unsafe combination therapies before versus after the interventions, and reevaluate the analyses of barriers to effective treatment, including safety concerns. Methods: An ad hoc report was run on patients with hyperlipidemia from August 2002 through January 2003. Patients were then matched to the 527 patients identified from the previous lipid study as experiencing therapeutic failure. Primary endpoints included comparisons of the most current LDL value to previous LDL values, as well as changes in lipid-lowering therapies, combination regimens, and goal-attainment rates. Results: Statistically significant reductions in LDL were noted for patient subgroups in the CHD or CHD-risk-equivalent category, as well as the multiple risk factor category. These reductions amounted to a 33.6 mg/dL (24.4 percent) LDL reduction among CHD or CHD-risk-equivalent patients, and a 41.05 mg/dL (26.1 percent) reduction in LDL among those in the multiple risk factor category. Of the 310 patients with previous treatment failure whose goal attainment was reviewed, LDL values were available for 255 patients. Of these patients, 175 (68.6 percent) were now at LDL goal, compared to none from the previous review. This result was statistically significant (P < 0.001). Organized by risk category, LDL goal attainment showed a 53.2 percent increase among the 109 highest risk (CHD or CHD-risk-equivalent) patients and increased 80.1 percent among 146 multiple risk factor patients. Average LDLs were reduced by 38 mg/dL in all patients and by an average of 41 mg/dL among the highest risk category patients. Conclusion: Results demonstrated significant improvements in LDL values among patients with previous therapeutic failures after implementation of a variety of pharmacy interventions. .

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