| Cost of a pharmacist-directed intervention to increase treatment of hypercholesterolemia. | |
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MedLine Citation:
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PMID: 15338855 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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STUDY OBJECTIVE: To evaluate the cost of a pharmacist-directed intervention that prompts physicians to treat hypercholesterolemia more aggressively in patients with coronary heart disease (CHD). METHODS: Health care resource use and CHD outcomes were evaluated for 612 patients with CHD followed for 2 years after an index hospitalization for an ischemic event. After discharge, the physicians of 309 patients who had been admitted from January 1--March 31, 1999, were contacted by telephone and mail concerning lipid profiles and statin therapy. These patients were the intervention group. Controls were 303 patients admitted from October 1--December 31, 1998; their physicians were not contacted. Costs of the physician-prompting intervention, clinic visits, laboratory tests, statin drugs, and CHD outcomes were compared between these two patient groups. RESULTS: The number of clinic visits, laboratory tests, and statins prescribed was significantly greater for the intervention group versus the controls. A significantly higher percentage of patients in the intervention group (55%) than in the control group (18%) achieved their National Cholesterol Education Program target low-density lipoprotein cholesterol level and had significantly better CHD outcomes. The cost of the physician-prompting intervention (pharmacist salaries, postage, telephone calls) was $102,941. For patients in the intervention and control groups, respectively, the cost of statin therapy was $352,365 and $200,087, the cost of clinic visits and laboratory tests $48,097 and $27,367, and the cost of coronary heart disease outcomes, such as myocardial infarction, coronary artery bypass graft, percutaneous transluminal and coronary angioplasty, $1,073,495 and $1,741,220. The total cost was $1,576,898 and $1,968,674, respectively, for patients in the intervention and control groups. Net savings was $1394/patient over the 2-year period. CONCLUSION: A relatively simple physician-prompting intervention involving patients with CHD significantly improved the use of lipid testing and statin therapy. Improved use of statins was associated with better CHD outcomes. As a result, the physician-prompting intervention was associated with cost savings. This intervention should be implemented for patients with CHD discharged after hospitalization for an ischemic event. |
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Authors:
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Daniel E Hilleman; Michele A Faulkner; Michael S Monaghan |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Pharmacotherapy Volume: 24 ISSN: 0277-0008 ISO Abbreviation: Pharmacotherapy Publication Date: 2004 Aug |
Date Detail:
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Created Date: 2004-09-01 Completed Date: 2004-10-26 Revised Date: 2005-11-16 |
Medline Journal Info:
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Nlm Unique ID: 8111305 Medline TA: Pharmacotherapy Country: United States |
Other Details:
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Languages: eng Pagination: 1077-83 Citation Subset: IM |
Affiliation:
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School of Pharmacy and Health Professions, Creighton University Medical Center, Omaha, Nebraska 68178, USA. hilleman@creighton.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Case-Control Studies Coronary Disease / complications, economics Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors / economics, therapeutic use* Hypercholesterolemia / complications, drug therapy*, economics Middle Aged Pharmaceutical Services / economics* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Hydroxymethylglutaryl-CoA Reductase Inhibitors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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