Comparison of cardiovascular risk calculation tools in pharmacy practice

• Published in: Journal of the American Pharmacists Association Vol. 53; no. 4; pp. 408 - 413
• Main Authors: White, Nicole D., PharmD, Lenz, Thomas L., PharmD, MA, PAPHS, FACLM, Skrabal, Maryann Z., PharmD, CDE, Faulkner, Michele A., PharmD, Skradski, Jessica J., PharmD, Southard, Leslie A, Popken, Derek E
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-07-2013
• Subjects: Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - etiology; Cardiovascular Diseases - prevention & control; cardiovascular risk; Chronic Disease; Decision Support Techniques; Diabetes Mellitus - diagnosis; Diabetes Mellitus - therapy; Disease Management; Dyslipidemias - complications; Dyslipidemias - diagnosis; Dyslipidemias - therapy; Female; Humans; Hypertension - complications; Hypertension - diagnosis; Hypertension - therapy; Internal Medicine; Longitudinal Studies; Male; Middle Aged; Midwestern United States; Occupational Health Services; Pharmaceutical Services; pharmacists; Prognosis; Risk Assessment; Risk Factors; risk reduction; Time Factors; Universities; Midwestern United States; risk reduction; pharmacists; cardiovascular risk
• ISSN: 1544-3191; 1544-3450
• DOI: 10.1331/JAPhA.2013.12181

Abstract Objective To examine the use of various cardiovascular disease (CVD) risk estimation calculators in pharmacy practice. Design Longitudinal cohort study. Setting Midwestern university worksite from August 2008 through May 2012. Participants University employees with hypertension, dyslipidemia, and diabetes. Intervention Risk estimation calculators were applied to data from a pharmacist-run chronic disease management program. Main outcome measure Difference in estimated CVD risk from multiple estimation calculators. Results At baseline and 12 months, non–lab-based tools reported significantly higher 10-year CVD risk percentages compared with lab-based tools among the same cohort of patients (10.63% vs. 8.71% at baseline, P < 0.001; 9.34% vs. 7.31% at 12 months, P < 0.001). In addition, the electronic version of 10-year CVD risk reported significantly higher values than the paper version when applied to the same patient cohort (7.31% vs. 6.60% at 12 months, P = 0.018). Conclusion CVD risk estimation tools report significantly different values and are not interchangeable. Pharmacists using non–lab-based tools should expect significantly higher risk estimates than estimates derived from lab-based tools and therefore should use the same version of the estimation tool over the long term.