Report: CVD risk factors that pharmacists can address

The Community Preventive Services Task Force, an independent, uncompensated panel of public health and prevention experts, has released 3 recommendations to address risk factors for cardiovascular disease (CVD). Pharmacists were included as members of the team to help with interventions for CVD prevention.

These interventions included team-based care for CVD prevention, reduced out-of-pocket costs for medications to control high blood pressure and high cholesterol, and clinical decision-support systems (CDSS) for CVD prevention.

“The greatest promise for reducing CVD-related healthcare costs, pain, and suffering comes from preventing CVD from occurring in the first place, or from controlling it in its earliest stages,” according to the task force’s 2013 Annual Report to Congress.

Annual health expenditures and lost productivity in the United States related to CVD are estimated to be $444 billion, with coronary artery disease alone costing about $108.9 billion annually. Approximately 83 million Americans have CVD, the report said.

As far as the lack of evidence to support the effectiveness of team-based care, more evaluation of large-scale, real-world, team-based care initiatives is needed. The task force mentioned that there is minimal information that team-based care can encourage patients to adhere to healthy behaviors as part of their treatment plans. In addition, will team-based care work effectively for patients with different racial or socioeconomic status? And will team-based care continue to work long term?

The task force also wants to assess the effectiveness of reduced out-of-pocket costs for behavioral counseling or support services that are not part of reduced out-of-pocket medication costs. And will reduced out-of-pocket costs for older patients work for younger patients or individuals with different educational levels?

Evidence gaps for CDSS include the lack of information concerning long-term outcomes, patient satisfaction, the effect on patient adherence to medication and treatment plans, and the effect on other CVD risk factors.

“The Task Force notes gaps in evidence around how effective CDSS are when delivered by non-physician providers such as nurses and pharmacists,” the report said. “The Task Force also underscores the need for evaluation of large-scale, real-world CDSS.”

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