High Blood Pressure, Cholesterol Levels Noted Among Patients Managed by a Pharmacist

A 2.5% improvement in blood pressure and low-density lipoprotein (LDL) was noted among stroke patients who were managed by a pharmacist, a new study found

A 2.5% improvement in blood pressure and low-density lipoprotein (LDL) was noted among stroke patients who were managed by a pharmacist, a new study found.

Patients who have a stroke or "mini stroke" (transient ischemic attack) are at high risk of adverse cardiovascular events. Management of high blood pressure and cholesterol after a stroke is important because it can substantially reduce the risk of a negative event; however, many patients receive suboptimal care.

Cholesterol Rich Foods to Avoid to Lower Your High Cholesterol
List of food sources that have huge amounts of cholesterol and saturated fats bad for health. Cholesterol-rich foods article briefs about healthy eating tips, exercise, weight management.

Some evidence indicates designated "case managers" could better manage patients to reduce the risk.

Researchers undertook a randomized controlled trial to determine if a pharmacist case manager could improve blood pressure and cholesterol levels in people who had had strokes or mini strokes. The trial included 279 adult participants in Edmonton, Alberta, who either received care from a pharmacist or a nurse (control group) who managed the case over a 6-month period. About 60% of participants were 65 years of age or older and 58% were men.

Both nurses and pharmacists counselled participants on diet, smoking, exercise and other lifestyle factors; checked blood pressure and LDL levels and provided summaries to patients' physicians after each visit. In addition, pharmacists prescribed medications based on the current Canadian guidelines and adjusted doses to achieve the best result for each patient.

Fish: The Best and The Worst
Some fish are contaminated with high levels of methyl mercury. Methyl mercury is a neurotoxin, which affects the pregnant or lactating mother’s child’s brain.

At the start of the study, none of the participants had blood pressure or cholesterol levels that met targets recommended in the Canadian Stroke Guidelines. By 6 months, both groups had significant improvements, with a 30% improvement in the control group managed by nurses and a 43% improvement in patients managed by pharmacists.

"Calling our control arm "usual care" would be a misnomer, and patients in the active control group (nurse-led group) showed a 30% absolute improvement in risk factor control over a 6-month period," writes Dr. Finlay McAlister, Division of General Internal Medicine, and the Epidemiology Coordinating and Research (EPICORE) Centre, University of Alberta, with coauthors. "The 43% absolute improvement at 6 months seen in our pharmacist case manager group was achieved despite the fact that over three-quarters of patients were already taking an antihypertensive or lipid-lowering medication at baseline."

Advertisements

Hypertriglyceridemia - Causes Risk Factors Symptoms Signs Diagnosis Treatment
Triglycerides are a form of the fat, the major energy source found in our blood. High triglyceride levels/ hypertriglyceridemia are associated with conditions like pancreatitis.

The pharmacists did not receive additional training, but all were at similar stages of their careers and received the same patient educational materials and treatment guidelines.

Although patients in both groups had similar reductions in blood pressure, patients in the pharmacist-led group had greater improvements in LDL cholesterol targets (51%) compared with 34% in the nurse-led group. The researchers point out that the pharmacist case managers actively adjusted medication to achieve desired results (medication titration) and suggest this contributed to the beneficial effect. Several other studies involving case managers who did not have prescribing authority found minimal benefit.