ABSTRACT
Introduction: Community-based pharmacists are positioned uniquely to assist in the early detection of underlying cardiovascular disease (CVD) which affects approximately 50% of adults in the United States. Organizations utilize community-based pharmacists to conduct annual biometric health screenings to help employees identify health risks previously undetected. The goal of this study was to evaluate how community-based pharmacists could impact lifetime atherosclerotic cardiovascular disease (ASCVD) risk for a large population. Methods: This study was a retrospective analysis of annual pharmacist-led 15-minute biometric health screening data from a large regional community-based pharmacy chain. Employees between the ages of 20 and 79 who had completed at least three biometric health screenings between July 1, 2015 and June 30, 2020 were included. Incomplete biometric health screening records were excluded. To calculate lifetime ASCVD risk and identify perceived gaps in care, prescription fill history of study participants was used. The pharmacists did not make clinical interventions; however, education was provided with the information found. Results: A total of 10,001 patients were included. Median baseline ASCVD risk was 1.5% and increased to 1.8% (p < 0.001). Additionally, 1,187 patients with an elevated ASCVD risk ≥ 7.5%, showed statistically significant improvements in blood pressure, body mass index, and cholesterol. Conclusions: Improvements for high-risk patients were seen in several biometric health screening parameters including blood pressure, body mass index, and cholesterol. Community-based pharmacists were well positioned to intervene clinically to support reduction of ASCVD life-time risk.
ABSTRACT
BACKGROUND: Government and health care entities are seeking solutions to optimize safe opioid prescribing practices. Electronic prescribing of controlled substance (EPCS) state mandates are becoming common, but lack thorough evaluation. OBJECTIVE: This study aimed to evaluate whether EPCS state mandates affect opioid prescribing patterns for acute pain treatment. METHODS: This retrospective study was designed to assess prescribing patterns via percent change for quantity, day supply, and prevalence of prescribing method utilized for opioid prescriptions 3 months pre- and post-EPCS mandate. Prescription data are extracted from two regional divisions of a large community-based pharmacy chain between April 1, 2021 to October 1, 2021. Relationships of patient geographical locations and prescribing methods were assessed. Likewise, the relationship of opioids prescribed between insurance types were evaluated. Data was evaluated utilizing Chi-Square and Mann-Whitney U tests, with an a-priori alpha of 0.05. RESULTS: There was an increase before to after state mandate of quantity and day supply (0.8% and 1.3% [P = 0.02; P < 0.001], respectively). There were significant decreases in total daily dose and daily morphine milligram equivalent (2.0% and 1.9% [P < 001; P = 0.254], respectively). A 16.3% increase was seen in electronic prescribing before to after state mandate for prevalence of electronic prescribing versus other prescribing methods. CONCLUSION: There is a correlation between EPCS and prescribing patterns for acute pain treatment with opioids. The use of electronic prescribing increased after state mandate. By promoting the use of electronic prescribing, the benefit of awareness and caution of opioid use draws attention to prescribers.
