An Evaluation of Cholesterol Management Within a State Correctional System

Abstract

The objectives of this evaluation were to analyze the efficacy of cholesterol lowering therapy as outlined by the National Cholesterol Education Program (NCEP) guidelines and to determine the cost effectiveness of treating hyperlipidemia in the incarcerated patient. A retrospective chart review was conducted of 100 randomly selected charts identified through the pharmacy claims data. Criteria for inclusion were that patients had received at least 60 days of therapy and had a baseline LDL-C prior to drug initiation. Seventy-nine patients met these criteria. Overall, 71% (56) of patients achieved NCEP 2 goal LDL-C. Forty-five percent of patients with coronary heart disease (CHD) achieved a goal LDL-C of less than 100 mg/dL. Ninety-five percent of patients were compliant with their therapy (at least five refills in six months). It was hypothesized that over five years the system will prevent one CHD patient from having a coronary procedure and two fatal coronary events in the population reviewed. The results of this review reinforce the importance of effectively managing hyperlipidemia in a state correctional system.

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References

American Heart Association . (2000). AHA heart and stroke facts, statistical supplement. Dallas, Texas: Author.

De Muth, J. E. (1999). Basic statistics and pharmaceutical statistical applications. New York: Marcel Dekker.

Downs, J. R. , Clearfield

, Weis

, Whitney

, Shapiro, D. R. , Beere, P. A. , et al. (1998). Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels. Journal of the American Medical Association, 279, 1615-1622.

Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults . (2001). Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). Journal of the American Medical Association, 285, 2486-2497.

Lipid Goal Manager (Version 2.1) [Computer software]. New York: Pfizer.

The Long-Term Intervention With Pravastatin in Ischaemic Disease Study Group . (1998). Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. New England Journal of Medicine, 339, 1349-1357.

Pearson, T. A. , Laurora

, Chu

, & Kafonek

(2000). The lipid treatment assessment project. Archives of Internal Medicine, 160, 459-467.

Sacks, F. M. , Pfeffer, M. A. , Moye, L. A. , Rouleau, J. L. , Rutherford, J. D. , Cole, T. G. , et al. (1996). The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. New England Journal of Medicine, 335, 1001-1009.

Scandinavian Simvastatin Study Survival Group . (1994). Randomized trial of cholesterol lowering in 4,444 patients with coronary heart disease: The Scandinavian Simvastatin Survival Study (4S). Lancet, 344, 1383-1389.

10.

Shepherd

, Cobbe, S. M. , Ford

, Isles, C. G. , Lorimer, A. R. , Macfarlane, P. W , et al. (1995). Prevention of coronary heart disease with pravastatin in men with hypercholestero lemia. New England Journal of Medicine, 333, 1301-1307.