Mangum Stacy A, Kraenow Kim R, Narducci Warren A
J Am Pharm Assoc (Wash). 2003 Jan;43(1):50-5. doi: 10.1331/10865800360467042.
OBJECTIVE To demonstrate whether a community pharmacist can be successful in identifying and referring patients with elevated blood pressure and/or increased risk of stroke. SETTING An independent community pharmacy and well-elderly housing facility in rural Iowa. PRACTICE DESCRIPTION The pharmacy had dedicated space for patient care activities, had a community pharmacy practice resident, and served as a clerkship site for a local school of pharmacy. One of three well-elderly housing facilities in the same community was used as a screening site for the stroke prevention program. PRACTICE INNOVATION All adults entering the pharmacy during the time the blood pressure project was underway were offered a free blood pressure screening. If readings were elevated, patients were referred to their primary care provider. For stroke prevention, a screening using the American Heart Association stroke risk assessment protocol was held at the pharmacy and the well-elderly housing facility. MAIN OUTCOME MEASURES Blood pressure categories and stroke risk (normal, mild, moderate, and high) categories obtained during the screening. RESULTS A total of 351 patients were screened for hypertension. Of these, 216(62%) had readings greater than 140/90 mm Hg. Of the 121 patients referred to their physician, 43 (36%) had a regimen change. A total of 50 patients were screened for stroke risk. Results of the risk assessments for patients screened were normal, 4%; mild, 26%; moderate, 32%; high, 38%. CONCLUSION These projects demonstrated that, through ongoing screening programs, community pharmacists are in an ideal position to screen patients at risk for cardiovascular and cerebrovascular disease and refer patients to their physicians for further evaluation.
目的 证明社区药剂师能否成功识别并转诊血压升高和/或中风风险增加的患者。地点 爱荷华州农村的一家独立社区药房和老年公寓。实践描述 该药房设有专门的患者护理活动空间，有一名社区药房实习住院医师，并作为当地药学院的见习地点。同一社区的三所老年公寓之一被用作中风预防项目的筛查地点。实践创新 在血压项目进行期间，所有进入药房的成年人都可享受免费血压筛查。如果读数升高，患者会被转诊至其初级保健提供者处。为预防中风，在药房和老年公寓使用美国心脏协会中风风险评估方案进行了筛查。主要观察指标 筛查期间获得的血压类别和中风风险（正常、轻度、中度和高度）类别。结果 共有351名患者接受了高血压筛查。其中，216名（62%）读数高于140/90 mmHg。在转诊至医生处的121名患者中，43名（36%）更改了治疗方案。共有50名患者接受了中风风险筛查。筛查患者的风险评估结果为正常，4%；轻度，26%；中度，32%；高度，38%。结论 这些项目表明，通过持续的筛查项目，社区药剂师处于筛查心血管和脑血管疾病风险患者并将患者转诊至医生处进行进一步评估的理想位置。
