Ma Yunsheng, Ockene Ira S, Rosal Milagros C, Merriam Philip A, Ockene Judith K, Gandhi Pritesh J
Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
Cholesterol. 2010;2010:383281. doi: 10.1155/2010/383281. Epub 2010 Aug 17.
A randomized trial of a pharmacist-delivered intervention (PI) versus usual care (UC) was conducted; 689 subjects with known coronary heart disease were recruited from cardiac catheterization laboratories. Participants in the PI condition received 5 pharmacist-delivered telephone counseling calls post-hospital discharge. At one year, 65% in the PI condition and 60% in the UC condition achieved an LDL-C level <100 mg/dL (P = .29); mean statin adherence was 0.88 in the PI, and 0.90 in the UC (P = .51). The highest percentage of those who reached the LDL-C goal were participants who used statins as opposed to those who did not use statins (67% versus 58%, P = .05). However, only 53% and 56% of the patients in the UC and PI conditions, respectively, were using statins. We conclude that a pharmacist-delivered intervention aimed only at improving patient adherence is unlikely to positively affect outcomes. Efforts must be oriented towards influencing physicians to increase statin prescription rates.
开展了一项药剂师提供干预措施（PI）与常规护理（UC）的随机试验；从心脏导管实验室招募了689名已知患有冠心病的受试者。PI组的参与者在出院后接受了5次药剂师提供的电话咨询。一年时，PI组65%的参与者和UC组60%的参与者实现了低密度脂蛋白胆固醇（LDL-C）水平<100mg/dL（P = 0.29）；PI组他汀类药物的平均依从性为0.88，UC组为0.90（P = 0.51）。达到LDL-C目标的参与者中，使用他汀类药物的比例最高，而非使用他汀类药物的参与者（67%对58%，P = 0.05）。然而，UC组和PI组分别只有53%和56%的患者使用他汀类药物。我们得出结论，仅旨在提高患者依从性的药剂师提供的干预措施不太可能对结果产生积极影响。必须致力于影响医生提高他汀类药物的处方率。
