Cardiovascular Risk Reduction in the Workplace With CAMMPUS (Cardiovascular Assessment and Medication Management by Pharmacists at the UBC Site)

Abstract

Background: Cardiovascular (CV) disease is a leading cause of death despite being largely preventable. Employers increasingly offer preventive health programs in the workplace, and pharmacists are well suited to provide these programs. Objective: To evaluate the impact of a pharmacist-led service on CV risk in University of British Columbia (UBC) employees. Methods: This was a prospective observational pre-and-post design study, with participants as their own controls. Employees >18 years of age in the UBC health plan with a Framingham Risk Score (FRS) ≥10% or ≥1 medication-modifiable CV risk factor were included. Participants received a baseline assessment, individualized consultation for 12 months, and a final assessment by a pharmacist at the UBC Pharmacists Clinic. The primary end point was FRS reduction. Results: Baseline assessment of 512 participants between September 2015 and October 2016 yielded 207 (40%) participants, of whom 178 (86%) completed the 12-month intervention. Participants were 54% female and 55% Caucasian, with an average age of 51 (SD = 9.1) years. FRS at baseline was <10 in 45.8%, 10 to 19.9 in 37.9%, and ≥20 in 16.4% of participants. Over 12 months, significant reductions in average FRS (from 11.7 [SD = 7.7] to 10.7 [SD = 7.3]; P = 0.0017) and other parameters were observed. Significant improvements in quality of life (EQ5D change of 0.031 [95% CI = 0.001, 0.062] P = 0.023) and medication adherence (MMAS-8 change of 0.42 [ P = 0.019]) were also noted. Conclusions and Relevance: UBC employees had improvements in health markers, self-reported quality of life, and medication adherence after receiving a 12-month pharmacist-led intervention. Pharmacists are encouraged to provide CV risk reduction services in workplaces.

Participant perceptions of pharmacists and workplace wellness in CAMMPUS

“…This is also consistent with the objective improvements in cardiovascular health observed in these patients. 5 Ensuring a positive patient experience was a priority in the development and design of CAMMPUS, starting from the first point of contact with administrative staff and appointment scheduling process. Health care scheduling is an issue that is too often overlooked and can impede program success if it is not patient-friendly.…”

“…The complete methodology and interventions used in CAMMPUS have been published elsewhere. 5 To explore participant perceptions, a paper-based feedback survey was administered to each participant who received 12 months of service in CAMMPUS. Participants received and completed the survey in the Clinic immediately following the conclusion of their final follow-up consultation.…”

“…For 178 participants who each completed a 12-month program of service, results showed significant and beneficial reductions in predictors of cardiovascular risk (Framingham Risk Scores and blood pressure) and increased self-reported quality of life. 5 Pharmacists are well positioned to support local employers through preventive health programs, and an important aspect of pharmacist care is the patient perspective. One aspect of CAMMPUS was to evaluate the participant perceptions of the pharmacist approach and overall care.…”

Third-party Reimbursement of Pharmacist-Led Cardiovascular and Diabetes Preventive Health Services for Workplace Health Initiatives: A Narrative Systematic Review

“… 5 Preventive health programs initiated by workplace organizations or employers have demonstrated both clinical improvements and cost-savings in employee health outcomes, productivity and absenteeism. 6 , 7 , 8 , 9 …”

The Role of the Clinical Pharmacist in a Preventive Cardiology Practice

“…well positioned to help fill the chronic disease management gap and make a difference when they are actively engaged as part of a team-based care approach.” 2 Ample evidence supports the value of pharmacist intervention in improving outcomes, medication adherence, and cost in the ambulatory care setting. 3,7-14 A key determinant of these improved outcomes relates to increased access to medications, influenced significantly by patient out-of-pocket medication expense. 15-18 In that regard, the objective of this study was to describe the impact of interventions initiated by a clinical pharmacist within a preventive cardiology clinic, with an emphasis on patient cost avoidance.…”