PIM detection is likely to be overestimated using STOPP and PPO detection underestimated using START when STOPP/START is used in isolation of clinical information. Agreement for a selected number of criteria for which clinical information is not required is good, suggesting that some criteria may be reliably deployed without clinical information during a medicines use review. However, for STOPP/START criteria to be deployed more effectively by pharmacists, access to the full clinical record is recommended.

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Abstract:To review pharmacist-led screening programmes for estimation of cardiovascular disease (CVD) risk using validated screening tools, studies were identified using a search of the following electronic databases: PubMed, EMBASE, Web of Knowledge and the Cochrane library databases. Each database was searched from inception to December 2011. The search terms used were: "cardiovascular disease", "screening", "risk estimation", "pharmacist" and "pharmacy". Titles, abstracts and full manuscripts were screened to determine eligibility. Inclusion criteria were: (i) Pharmacist-led CVD screening; and (ii) Use of validated screening tool or tools for CVD. From each included study information was collected on the following: Study author; year of publication; setting; inclusion and exclusion criteria; tools used and outcomes measured. Articles were grouped and independently verified to ensure they met with the inclusion criteria. Over 7,000 citations were found. Twenty full-length articles were retrieved for analysis, of which twelve were excluded, as they did not meet the inclusion criteria. The eight remaining articles were included in this literature review. Whilst pharmacists undertake screening in their own practice, this approach will only go so far. To have a population-health impact, pharmacists should be involved in proactive screening in a variety of settings.

Point-of-care testing (POCT) devices can be used to both screen for dyslipidaemia and to monitor lipid levels of patients currently being treated for elevated cholesterol. This study aims to examine the precision of a POCT device when used in a primary care setting. Health screens were offered to all staff members of University College Cork, Ireland. Capillary whole blood samples were taken from two digits of each participant to assess the lipid profile using the POCT device. The relationship between both results was investigated using Pearson product-moment correlation coefficient, paired sample t-tests and Kappa measures of agreement. In the second part of the study a volunteer provided ten consecutive capillary whole blood samples. These results were used to calculate the co-efficient of variation of the device. Data were collected from 55 participants, 25(45%) of whom were male. The mean age of the study population was 44.5 AE 10.1 years. There were statistically significant differences recorded between the results for TC, TG and LDL-C. Coefficients of variation for TG and LDL-C were calculated at 7.51 and 7.71%, respectively. There is a degree of variability associated with the precision of POCT device; measurement error is a problem associated with cholesterol testing.Practical applications: Point-of-care testing devices are widely used to measure cholesterol levels. They are convenient for patients because only a small amount of blood is required, reducing discomfort. They also have the advantage of providing results quickly, at a location convenient and easily accessible to the patient. It is important that a POCT device being used for the purposes of screening and monitoring is both accurate and precise. This study aimed to examine the precision of a POCT device when used in a primary care setting. The results of this study are consistent with other studies that indicate that measurement error is a problem associated with cholesterol testing. If POCT devices are being used for screening or monitoring purposes then it is necessary to carefully calibrate the device in order to eliminate as much error as possible. Multiple readings should be performed using the same device to identify any potential outlier results.

Cardiovascular disease (CVD) was the leading cause of death in 2005, causing 17.5 million deaths globally. In Ireland, 2006 figures indicate that CVD was responsible for 43% of all deaths, and 49% of deaths in people aged less than 65 years. It is predicted to remain the largest cause of death for the foreseeable future. It has been estimated that at least 25% of CVD patients have sudden death or non-fatal myocardial infarction without prior symptoms. It is important to try to develop a method for screening these asymptomatic people. If people at high risk of CVD can be identified early then they can be treated to reduce their risk. This will in turn reduce their incidences of cardiovascular instances (heart attack, stroke, etc.) and their burden on the health service. Screening tools are used to identify those people at high risk of developing CVD. These screening tools take a ...