Identifying at-risk patients through community pharmacy-based hypertension and stroke prevention screening projects

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.