Consultant Pharmacists Impact on the Treatment of HypercholesterolemiaWhat is Cholesterol, and Why is it of Concern?
Guidelines for Treating Hypercholesterolemia
Management of Hypercholesterolemia
Management of Hypercholesterolemia By Different Health Care Workers.
Practical Management of Hypercholesterolemia
Community Pharmacists and the Management of Hypercholesterolemia
Economic Impact of Pharmacists' Treatment of Hypercholesterolemia
This paper will look at the impact of consultant pharmacists on the treatment of hypercholesterolemia by physicians. Pharmacists have now assumed responsibilities outside the dispensing counter and have been active in monitoring and treating (under protocol) patients with high cholesterol levels (as well as other disease states).
A review of the treatment of hypercholesterolemia by physicians by a group of consultant pharmacists who call on physicians offices, and check physicians progress by reference to the achievement of NCEP cholesterol guidelines, has shown that physicians are doing an overall poor job of getting their patients to national cholesterol treatment standards (NCEP guidelines).
This paper is therefore essentially a review of the problem, through an analysis of the fact that many patients are not achieving control of cholesterol despite treatment by their physicians. Some of the suspected reasons behind this will be discussed, through a review of related literature with summary of findings of research already conducted on this topic.
Firstly, cholesterol and the problems it presents to health will be discussed, and a short review of the various treatment options that are available will be presented, in order to show that hypercholesterolemia is - fundamentally - treatable, but that the management of this treatment is failing.
The thesis will then move on to discussing a review of research on the topic of why and how patients tend not to respond well to treatment of hypercholesterolemia by physicians, in terms of the lifestyle changes necessary to reduce cholesterol levels, and the various psychological and cultural barriers to cholesterol reduction.
The paper then moves on to a short review of the most relevant research on this topic, and then looks at the role pharmacists have played in helping physicians to reduce cholesterol levels in individuals, through a review of the relevant literature and a review of two short case studies, of the ImPACT program in the United States, and the SCRIP program in Canada.
Chapter 1: What is Cholesterol, and Why is it a Concern?
Cholesterol is a soft waxy substance that is a natural component of the fats in the bloodstream and in all the cells of the body, and while cholesterol is an essential part of a healthy body, high levels of cholesterol in the blood (known as hypercholesterolemia) increase a person's risk for cardiovascular disease, which can lead to stroke or heart attack (Anderson et al., 2001). When there is too much cholesterol circulating in the blood, it can create sticky deposits (plaques) along the artery walls, and plaque can eventually obstruct or even block the flow of blood to the brain, heart, and other organs (Anderson et al., 2001). A recent report indicates that more and more Americans have high cholesterol -- the condition is most common among those living in Western cultures (Anderson et al., 2001). While heredity may be a factor for some people, increasingly sedentary lifestyles combined with diets high in saturated fats appear to be the main culprits (Anderson et al., 2001).
The normal range for total blood cholesterol is between 140 and 200 mg per decilitre (mg/dL) of blood (Anderson et al., 2001). Levels between 200 and 240 mg/dL indicate moderate risk, and levels surpassing 240 mg/dL indicate high risk (Anderson et al., 2001). While total cholesterol level is important, it does not tell the whole story, as there are two main types of cholesterol: low density lipoproteins (LDL) and high density lipoproteins (HDL): HDL is generally considered to be "good" cholesterol, while LDL is considered "bad" (Anderson et al., 2001). Triglycerides are a third type of fatty material found in the blood, and while their role in heart disease is not entirely clear, it appears that as triglyceride levels rise, levels of "good" cholesterol fall (Anderson et al., 2001). The complex interaction of these three types of lipids is thrown out of balance when a person has hypercholesterolemia (Anderson et al., 2001). High cholesterol is characterized by a combination of elevated levels of LDL cholesterol, normal or low levels of HDL cholesterol, and normal or elevated levels of triglycerides (Anderson et al., 2001).
Signs and...
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