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BRIAN G. SANDHOFF, PHARM.D., BCPS, is Clinical Pharmacy Specialist, Kaiser Permanente of Colorado (KPCO), Aurora, and Clinical Assistant Professor, School of Pharmacy, University of Colorado at Denver and Health Sciences Center (UCDHSC), Denver. LESLIE K. NIES, PHARM.D., BCPS, is Clinical Pharmacy Specialist, KPCO, and Clinical Assistant Professor, School of Pharmacy, UCDHSC. KARI L. OLSON, PHARM.D., BCPS, is Clinical Pharmacy Specialist, KPCO, and Clinical Assistant Professor, School of Pharmacy, UCDHSC. JAMES D. NASH, PHARM.D., BCPS, is Clinical Advisor, Clinical Pharmacy Programs, Humana Inc., Louisville, KY. JON R. RASMUSSEN, PHARM.D., BCPS, is Clinical Pharmacy Specialist, KPCO, and Clinical Assistant Professor, School of Pharmacy, UCDHSC. JOHN A. MERENICH, M.D., is Endocrinologist, Colorado Permanente Medical Group, Denver, and Clinical Associate Professor of Medicine, UCDHSC.

Address correspondence to Dr. Sandhoff at the Clinical Pharmacy Cardiac Risk Service, Kaiser Permanente of Colorado, 16601 East Centretech Parkway, Aurora, CO 80011 (brian.g.sandhoff{at}kp.org).

Purpose. A clinical pharmacy service for managing the treatment of coronary artery disease in a health maintenance organization is described. Summary. Despite the proven benefits of aggressive risk factor modification for patients with coronary artery disease (CAD), there remains a treatment gap between consensus- and evidence-based recommendations and their application in patient care. In 1998, Kaiser Permanente of Colorado developed the Clinical Pharmacy Cardiac Risk Service (CPCRS) to focus on the long-term management of patients with CAD to improve clinical outcomes. The primary goals of the CPCRS are to increase the number of CAD patients on lipid-lowering therapy, manage medications shown to decrease the risk of future CAD-related events, assist in the monitoring and control of other diseases that increase cardiovascular risk, provide patient education and recommendations for nonpharmacologic therapy, and act as a CAD information resource for physicians and other health care providers. Using an electronic medical record and tracking database, the service works in close collaboration with primary care physicians, cardiologists, cardiac rehabilitation nurses, and other health care providers to reduce cardiac risk in the CAD population. Particular attention is given to dyslipidemia, blood pressure, diabetes mellitus, and tobacco cessation. Treatment with evidence-based regimens is initiated and adjusted as necessary. Over 11,000 patients are currently being followed by the CPCRS. Conclusion. A clinical pharmacy service in a large health maintenance organization provides cardiac risk reduction for patients with CAD and helps close treatment gaps that may exist for these patients. Index terms: Antilipemic agents; Coronary disease; Disease management; Health maintenance organizations; Patient information; Team

 

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				C. L. LaCivita Improving the quality of care for coronary artery disease Am. J. Health Syst. Pharm., January 1, 2007; 64(1): 35 - 35. [Full Text] [PDF]