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Achieving cholesterol target in a managed care organization (ACTION) trial
Robert J Straka1, Reza Taheri, Susan L Cooper
1Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota 55455, USA. strak001@umn.edu
Pharmacotherapy
|April 22, 2005
Summary
Pharmacist-led collaborative care significantly improved low-density lipoprotein cholesterol (LDL) control in coronary heart disease (CHD) patients. This approach demonstrated sustained benefits even after the intervention ended, optimizing patient outcomes.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Background:
- Coronary heart disease (CHD) management requires effective control of low-density lipoprotein cholesterol (LDL) to reduce cardiovascular risk.
- Current treatment strategies may not achieve optimal LDL goals in all patients.
- The National Cholesterol Education Program Adult Treatment Panel III recommends optimizing lipid management.
Purpose of the Study:
- To compare a collaborative pharmacist-led approach with usual care for achieving LDL goals in outpatients with CHD.
- To assess the sustainability of LDL goal achievement after the collaborative intervention is removed.
Main Methods:
- Prospective, multiclinic, controlled study involving 481 outpatients with CHD not at their LDL goal.
- Intervention group received physician-approved care plans managed by clinical pharmacists, including lipid-lowering drug management and patient education.
- Control group received usual care.
Main Results:
- After 6.5 months, 72% of the intervention group achieved their LDL goal (<100 mg/dl) compared to 18% in the control group (p<0.001).
- Mean LDL levels decreased by 27.5% in the intervention group versus 4.6% in the control group (p<0.001).
- At 18 months post-intervention, 65% of intervention patients remained at goal, compared to 42% of controls (p<0.001).
Conclusions:
- A collaborative pharmacist-led approach is effective in optimizing LDL management for patients with CHD.
- This model demonstrates significant and sustainable improvements in lipid control within managed care settings.
- The findings support the integration of collaborative care models into routine clinical practice for cardiovascular risk reduction.