Research Note
Community pharmacist assessment of 10-year risk of coronary heart disease for union workers and their dependents
Yifei Liu, PhD; Leslie J. Mentele, PharmD; Randal P. McDonough, MS, PharmD; Kara M. Carruthers, PharmD; William R. Doucette, PhD
J Am Pharm Assoc (2003) 2008;48:515-517. doi:10.1331/JAPhA.2008.07099


Objective  To determine 10-year coronary heart disease (CHD) risk for union workers and their dependents in a pharmacist-managed health screening program.

Methods  Two local unions of plumbers and electricians contracted with a community pharmacy to provide health screening services for union workers and their dependents. Patients chose any one or any combination of three clinical tests: blood pressure, total cholesterol, and HDL cholesterol. At the end of the screening, which took approximately 35 minutes, the participants received brief patient education from pharmacists and a printout of their results. Pharmacists provided the services based on their in-store screening experience and, before the screening, received training on 10-year CHD risk calculation and guidelines regarding cholesterol treatment. Framingham scoring was applied to calculate 10-year CHD risk for participants who chose all three clinical tests.

Results  265 patients (55.8% men, average age 57.7 years) participated in the screening program. Frequency of cardiovascular disease (CVD) risk factors ranged from 25.5% (diastolic blood pressure) to 52.5% (total cholesterol). Using Framingham scoring, 10-year CHD risk was calculated for 226 patients, with 119 (52.7%) patients having less than 10% risk with zero to one CVD risk factor, 73 (32.3%) having 10% to 20% risk with two or more CVD risk factors, and 34 (15%) having greater than 20% risk with two or more risk factors.

Conclusion  Pharmacists provided intermediate- and high-risk participants with guideline-based recommendations such as referring them to physicians for further assessment, therapeutic lifestyle changes, and medication treatment. Community pharmacists were able to identify individuals with intermediate or high 10-year CHD risk. Based on 10-year CHD risk assessment, further pharmacist-managed interventions, such as a cardiovascular risk management program, can be conducted.

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