Date of Award

1988

Document Type

Dissertation

Degree Name

Doctor of Philosophy (Ph.D.)

Department

Graduate School

First Advisor

Patrick N. Catania

First Committee Member

Arthur F. Harralson

Second Committee Member

Michael A. Mergener

Third Committee Member

Katherine Knapp

Fourth Committee Member

Fuad M. Nahhas

Abstract

The purpose of this research project was to evaluate the role of the community pharmacist in screening, identifying, and referring ambulatory patients with high total blood cholesterol (TBC) in a community pharmacy. Fifty seven patients, out of 241 initially screened individuals, met the study inclusion criteria and were accepted into this study. Of these 57 patients, 51 patients completed the six month study period. The normal population group consisted of 164 participants with TBC < 200 mgjdL at the initial cholesterol testing (visit 1). The drop out group represented six patients who failed to continue attending the two follow up tests (visit 2 and 3). For screening purposes, a non-fasting whole blood sample was used to measure TBC using the Boehringer Mannheim Reflotron analyzer.

The project was evaluated based on mean TBC levels obtained during the initial screening and the two follow up tests, pre-test and post-test scores, behavior and lifestyle changes, and the number of patients who received a physician's order for lipid analysis as a result of initial screening results. In addition, influence of age and educational background on lowering TBC in visits 2 and 3, patient acceptance of blood screening in a community pharmacy and willingness to pay for this service in the future were also determined.

To assess the level of significance among the means of the tested parameters, both parametric (one-way analysis of variance, Scheffe's post hoc test and two sample t-test) and non-parametric statistics (Mann-Whitney and chi-square test) were used at a probability level of less than 0.05. There was a significant difference in mean TBC levels between visit 1 and 2, and between visit 1 and 3 (P< 0.01). However, no statistically significant difference was found between visit 2 and 3 (P= 0.48). In addition, there was no significant difference in the incidence of high blood cholesterol in terms of gender or age difference at the initial screening. Further, mean TBC levels between males and females remained statistically insignificant during the two follow up tests. However, younger patients were able to lower their mean TBC level in visit 2 and 3 compared with older patients (P=< 0.031). The one-way analysis of variance results showed that there was no statistically significant difference in TBC changes during the three visits by subjects categorized by educational background levels. Patient's attitude toward the idea of blood test measurement in community pharmacies was positive. Ninety eight percent of the study group stated that they strongly liked such an idea, 92.16% expressed a willingness to pay an average of $4.55 (range $3 or less to $10), and all agreed that it was a convenient service for them.

It was concluded that cholesterol screening in this community pharmacy was effective and acceptable, and may prove to be financially feasible when effectively planned and marketed. This service provides the community pharmacist with an opportunity to offer a unique patient-oriented public service.

Pages

150

Share

COinS