JAPhA: Interaction, medicine improve costs and health of patients with hypertension and dyslipidemia

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Patients being treated for hypertension and dyslipidemia who received education and long-term medication therapy management services from a pharmacist achieved significant clinical and economic improvements sustained for up to six years, according to a study in Jan. 28 issue of the Journal of the American Pharmacists Association.

The Asheville Project, a community-based, pharmacist-directed, medication therapy management (MTM) program provided for several employers in the Asheville, N.C. area, conducted a study of 620 individuals being treated for hypertension and dyslipidemia.

“The results of each study [in the Asheville Project] – seen also in this recent data of patients with hypertension and dyslipidemia – show that medication utilization increased nearly threefold, yet total healthcare costs decreased, primarily as a result of fewer emergency room and hospital visits.  Much of this improvement can be attributed to the increased role the pharmacist played in providing health education and medication management guidance to these patients,” said Barry A. Bunting, PharmD, former clinical manager of pharmacy services, Mission Hospitals in Asheville, N.C.

Clinical and economic benefits resulting from hypertension and dyslipidemia risk reduction education and long-term MTM by pharmacists were demonstrated in 12 community and hospital pharmacy settings over a six-year period. Several clinical indicators of cardiovascular health improved over the course of the study, including:

  • Percentage of patients at blood pressure goal increased from 40.2% at the start of the study to 67.4% by the study’s end.
  • Mean LDL cholesterol decreased from 127.2 mg/dL at the start of study to 108.3 mg/dL by the study’s end.
  • Cardiovascular event rates fell by almost one-half, from 77 per 1,000 person–years during the historical period to 38 per 1,000 person–years during the study.

“With the Asheville Project, we saw a community-based disease management program that provides cardiovascular risk reduction education and face-to-face counseling by specially trained community and hospital pharmacists that resulted in significant clinical and financial outcome improvements,” said William M. Ellis, RPh, executive director and CEO, American Pharmacists Association (APhA) Foundation.

A cost benefit advantage was also demonstrated in a population with generally good baseline cardiovascular status (620 patients). The mean cost per cardiovascular event in the study period was $9,931, compared with $14,343 during the historical period. 

During the study period, cardiovascular-related medical costs decreased by 46.5%, accounting for only 19% of total healthcare costs, down from 30.6%. The authors wrote that this indicates that aggressively pursuing improvements in cardiovascular outcomes through pharmacist intervention in a broad population that includes at-risk patients, as well as patients who have yet to experience a cardiovascular event, can be cost effective.

Novartis to the APhA Foundation provided the funding for the study.