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Updated: May 20, 2025
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Encouraging Pharmacist Referrals for Evidence-Based Statin Initiation: Two Cluster Randomized Clinical Trials
Alexander C Fanaroff1,2,3, Qian Huang3, Kayla Clark3
1Division of Cardiovascular Medicine, University of Pennsylvania, Philadelphia.
JAMA Cardiology
|March 26, 2025
Summary
A pharmacist-led intervention significantly increased statin prescribing for high-risk patients. Asynchronous referrals to pharmacists for lipid management proved more effective than electronic health record alerts.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Health Services Research
Background:
- Most patients indicated for statin therapy are undertreated, despite statins' proven benefits in preventing major adverse cardiovascular events.
- Limited clinician time and lack of systematic preventive care efforts contribute to gaps in statin prescribing.
Purpose of the Study:
- To evaluate the impact of two interventions on increasing statin prescribing rates.
- To determine the effectiveness of pharmacist-led lipid management referrals for appropriate patients.
Main Methods:
- Two pragmatic cluster randomized clinical trials involving 12 primary care practices.
- Trial 1: Visit-based electronic health record (EHR) alert intervention.
- Trial 2: Asynchronous, semiautomated pharmacist referral intervention.
Main Results:
- The EHR alert intervention (Trial 1) did not significantly increase statin prescriptions compared to usual care (15.6% vs 11.6%).
- Semiautomated pharmacist referrals (Trial 2) significantly increased statin prescriptions by 16.4 percentage points compared to usual care (31.6% vs 15.2%).
Conclusions:
- Asynchronous semiautomated referrals for pharmacist comanagement substantially increase statin prescribing.
- This pharmacist-involved strategy offers a scalable and effective approach to improve statin use in high-risk populations.
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