Clinical and economic impact of ambulatory care clinical pharmacists in management of dyslipidemia in older adults: The IMPROVE study

We examined the impact of ambulatory care clinical pharmacist interventions on clinical and economic outcomes of 208 patients with dyslipidemia and 22 9 controls treated at nine Veterans Affairs medical centers. This was a ran domized, controlled trial involving patients at high risk of drug-related p roblems. Only those with dyslipidemia are reported here. In addition to usu al medical care, clinical pharmacists were responsible for providing pharma ceutical care for patients in the intervention group. The control group did not receive pharmaceutical care. Seventy-two percent of the intervention g roup and 70% of controls required secondary prevention according to the Nat ional Cholesterol Education Program guidelines. Significantly more patients in the intervention group had a fasting lipid profile compared with contro ls (p=0.021). The absolute change in total cholesterol (17.7 vs 7.4 mg/dl, p=0.028) and low-density lipoprotein (23.4 vs 12.8 mg/dl, p=0.042) was grea ter in the intervention than in the control group. There were no difference s in patients achieving goal lipid values or in overall costs despite incre ased visits to pharmacists. Ambulatory care clinical pharmacists can signif icantly improve dyslipidemia in a practice setting designed to manage many medical and drug-related problems.