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Impact of live medication therapy management on cholesterol values in patients with cardiovascular disease

Ricky Thumar, Kathy Zaiken

    Journal of the American Pharmacists Association : Japha
    |September 14, 2014
    PubMed

    Insights

    Live medication therapy management (MTM) significantly improved low-density-lipoprotein (LDL) cholesterol in cardiovascular disease (CVD) patients more than chart-review MTM. Live MTM achieved greater LDL reductions and goal attainment.

    Area of Science:

    • Cardiology
    • Pharmacology
    • Health Services Research

    Background:

    • Cardiovascular disease (CVD) management requires effective strategies for lowering low-density-lipoprotein (LDL) cholesterol.
    • Medication Therapy Management (MTM) is a crucial component of optimizing patient outcomes in chronic disease care.
    • Comparing different MTM delivery models is essential for enhancing clinical practice.

    Purpose of the Study:

    • To compare the effectiveness of live, primary care-based MTM versus standard chart-review MTM.
    • To evaluate the impact on LDL cholesterol reduction in patients with established CVD.
    • To assess the rates of LDL goal attainment and clinical pharmacist (CP) recommendation implementation.

    Main Methods:

    • A 6-month comparative study involving patients with CVD not at their LDL goal.
    • Two MTM groups: live, one-on-one pharmacist-physician interaction and chart-review with electronic medical record (EMR) communication.
    • Primary outcomes: mean LDL reduction, percentage of patients achieving LDL goal, and CP recommendation implementation rate.

    Main Results:

    • Live MTM resulted in a significantly greater mean LDL reduction (62 mg/dL ± 28.3 mg/dL) compared to chart-review MTM (36 mg/dL ± 23.2 mg/dL) (P=0.001).
    • A higher percentage of patients achieved their LDL goal in the live MTM group (51.3%) versus the chart-review group (30%) (P=0.006).
    • Implementation of CP recommendations was significantly higher in the live MTM group (86.3%) compared to chart-review MTM (66.3%) (P=0.003).

    Conclusions:

    • Live, pharmacist-led MTM services demonstrate superior efficacy in reducing LDL cholesterol for CVD patients compared to chart-review MTM.
    • Live MTM significantly improves LDL goal attainment and the implementation rate of clinical pharmacist recommendations.
    • These findings support the adoption of live MTM protocols in primary care settings for enhanced CVD management.
    Abstract

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