School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
J Cardiovasc Pharmacol Ther. 2011 Mar;16(1):43-52. doi: 10.1177/1074248410380207. Epub 2010 Oct 5.
To assess the clinical and economic outcomes of a clinical pharmacy service (CPS) in dyslipidemic management.
This was a 24-month prospective controlled trial conducted at the lipid clinic of a public hospital in Hong Kong. In the intervention group, a clinical pharmacist assessed low-density lipoprotein cholesterol (LDL-C) levels and provided recommendations in accordance to the Adult Treatment Panel III (ATP III) guidelines. Medication compliance and the proper use of drugs were assessed. Education on healthy lifestyles was reinforced. Monthly telephone follow-ups were made to check on the progress of patients. In the control group, patients received usual medical care with no pharmacist intervention. Primary outcome was the percentage of patients achieving the ATP III LDL-C goal at the end of study. The estimated cost of such service was also evaluated.
A total of 300 patients were recruited into the study (150 in intervention group and 150 in control group). In the intervention group, 58.7% patients achieved LDL-C goals compared with 45.3% in the control group (P < .05). The intervention group achieved 26.4%, 17.4%, and 30.0% mean reduction in LDL-C, total cholesterol (TC), and triglycerides (TG) levels, respectively, compared with 12.6%, 6.6%, and 11.5% in the control group (P < .05). The estimated cost for this clinical service was US$385/month for a total of 600 dyslipidemic patients seen per year.
The results of this study demonstrate the positive impact CPS can have on achieving treatment goals in lipid management. Similar services for other problematic conditions such as hypertension and diabetes mellitus may also be benefited by similar CPSs.
评估临床药学服务（CPS）在血脂异常管理中的临床和经济效果。
这是一项在香港公立医院脂质诊所进行的为期 24 个月的前瞻性对照试验。在干预组中，临床药师评估了低密度脂蛋白胆固醇（LDL-C）水平，并根据成人治疗小组 III（ATP III）指南提供了建议。评估了药物依从性和药物的正确使用情况。强化了健康生活方式的教育。每月通过电话随访检查患者的进展情况。在对照组中，患者接受了常规医疗护理，没有药师干预。主要结果是研究结束时达到 ATP III LDL-C目标的患者比例。还评估了该服务的估计成本。
共有 300 名患者入组研究（干预组 150 例，对照组 150 例）。在干预组中，58.7%的患者达到了 LDL-C 目标，而对照组为 45.3%（P<.05）。与对照组相比，干预组的 LDL-C、总胆固醇（TC）和甘油三酯（TG）水平分别降低了 26.4%、17.4%和 30.0%，而对照组分别降低了 12.6%、6.6%和 11.5%（P<.05）。这项临床服务的估计费用为每个月 385 美元，每年可治疗 600 名血脂异常患者。
这项研究的结果表明，CPS 可以对实现脂质管理治疗目标产生积极影响。类似的服务对于高血压和糖尿病等其他问题状况也可能受益于类似的 CPS。
