Outcomes of a multidisciplinary partnership to improve cardiac wellness: an opportunity for pharmacists.

OBJECTIVE

To describe the results of an initiative to create awareness of coronary heart disease and provide education regarding cardiovascular (CV) risk and cholesterol (lipid) management in a community-based senior population. A multidisciplinary partnership composed of governmental agencies, a member of the pharmaceutical industry, a college of pharmacy, and several community-based health care practitioners collaborated in the program.

DESIGN

Prospective CV risk assessment, educational interventions, and follow-up.

SETTING

Community centers providing wellness and activity programs for ambulatory seniors.

PATIENTS

Ambulatory senior adults who were active participants in senior center programs were invited to participate in a series of health screenngs at a center-based health fair. Those who met specific evidence-based qualifying criteria were enrolled in the program.

MAIN OUTCOME MEASURES

Changes in CV risk profile, specifically, total cholesterol, low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C), triglycerides (TG), blood glucose levels; and attainment of National Cholesterol Education Program (NCEP) lipid goals of the Adult Treatment Panel III.

RESULTS

Initial screening of 501 patients for eligibility allowed 273 patients to qualify and enroll in the program. A total of 112 (41.0%) participants returned for the year 2 follow-up, leaving a loss to follow-up of 161 patients. Compared with baseline, reductions occurred in total cholesterol (206.8 mg/dL vs.182.9 mg/dL), LDL-C (122.2 mg/dL vs. 105.5 mg/dL), HDL-C (51.5 mg/dL vs. 49.6 mg/dL), TG (164.8 mg/dL vs. 136.4 mg/dL), and blood glucose (115 mg/dL vs. 106.3 mg/dL); the number of patients with less than two risk factors decreased from 43 (38.4%) to 28 (25.0%) and those with two or more risk factors increased from 69 (61.6%) to 84 (75.0%); the number of patients at NCEP (lipid) goal increased from 57 (50.9%) to 80 (71.4%).

CONCLUSION

For senior adults participating in the program, improvements occurred in both the lipid profiles and the number of patients at their NCEP (lipid) goal, although the number of seniors with > or = two risk factors increased from 69 (61.6%) to 84 (75.0%). A multidisciplinary partnership for improving the CV health and awareness of an ambulatory senior population is a unique opportunity for pharmacists to provide wellness services for seniors.