Management of dyslipidemias: establishing a clinic run by clinical pharmacy specialists.

Because of the increasingly high incidence of heart disease in American Indians and the limited amount of information on the subject, the Santa Fe Indian Hospital first examined its patients' risk for and usual treatment of coronary artery disease (CAD) and then established a lipid clinic. The study showed that high-risk patients were being undermanaged. The clinic was established with the following purposes: to decrease CAD mortality, to delay/prevent cardiac occurrences, and to optimize drug therapy in primary and secondary CAD prevention patients. Treatment is managed by pharmacy practitioners who are credentialed clinical pharmacy specialist primary care providers. The clinic is set up to do screening and evaluation of patients. This is followed by patient education and support, appropriate drugs, and tests designed to monitor the drug therapy. Drug treatment follows prescription guidelines concordant with the NCEP II guidelines for dietary and therapeutic interventions. Program evaluation will take place in 1998 as a result of funding from the IHS Research and Evaluation Project.