High blood cholesterol levels continue to be a public health concern because they are a major risk for developing heart disease. Public screenings for patients at risk—which began in the 1990s with little pharmacist involvement—have evolved into a starting point for some pharmacies to provide pharmaceutical care services.
Editor's note: This is the second installment of a new quarterly feature designed to help pharmacists set up a variety of screening and management services.
Resources for developing a cholesterol screening program
CLIA information: http://www.cms.hhs.gov/pf/printpage.asp?ref=http://18.104.22.168/clia/Default.asp?
Cholestech training: http://www.cholestech.com/support/training/
Update of ATPIII Guidelines; Patient Education about Cholesterol: http://www.nhlbi.nih.gov/chd/
On-line Risk Calculator: http://hin.nhlbi.nih.gov/atpiii/calculator.asp?usertype=prof/
High blood cholesterol levels continue to be a public health concern because they are a major risk for developing heart disease. Public screenings for patients at risk-which began in the 1990s with little pharmacist involvement-have evolved into a starting point for some pharmacies to provide pharmaceutical care services.
"I think for it to really be useful, it has to be a part of a pharmaceutical care practice and a pharmaceutical care philosophy," stated Paul Jungnickel, Ph.D., associate dean and professor, Auburn University School of Pharmacy, Auburn, Ala.
According to Paula Carlson, Pharm.D., the Nishna Valley Pharmacy in Shenandoah, Iowa, initiated cholesterol screening not only to improve patients' cardiovascular care, but also because "it's an easy thing a pharmacist can do, and it's a great way to strengthen the communication among a patient, a pharmacist, and the doctor if it's done right. The stronger we make that relationship, the better off our patient outcomes are going to be."
What are the steps to setting up such a service?
Step 1: Foundational planning
"Next, depending on what equipment you use, you're going to have to get a Clinical Laboratory Improvement Amendments [CLIA] waiver," noted Maffeo. Maria Brous, director of media and community relations for Publix Super Markets, Lakeland, Fla., said the chain's stores that offer cholesterol screening have a CLIA waiver that allows them to handle blood.
Maffeo continued, "You also need to have a blood-borne pathogen control plan. As part of that blood-borne pathogen control plan you need to come up with a policy-do you require your staff to have hepatitis B immunizations? Do they have to sign a waiver?" A template for developing a blood-borne pathogen control plan is available at the Occupational Safety & Health Administration (OSHA) Web site (see box on resources). A sharps policy-how you deal with lancets or any other sharp instruments used-is also needed.
"I'd start with developing a business plan," McDonough said. Before he launched his services, he analyzed questions such as: Who is my target market? Who are some of the stakeholders? Which physicians would be willing to work with us? Which patients will I try to recruit? How will I market this?