National survey of pharmacists about coronary heart disease, hypercholesterolemia, nonprescription statin therapy, and pharmacists' services

Objective: To determine the beliefs and attitudes of pharmacists about the significance of high blood cholesterol, coronary heart disease (CHD), nonprescription statin therapy for patients at moderate risk for CHD, and their role in support of cholesterol-lowering treatments in patients. Design: Cross-sectional survey. Setting: Nationwide sample of licensed pharmacists in ambulatory practice in the United States drawn randomly from databases of the American Pharmacists Association. Participants: 104 independent pharmacists and 169 chain pharmacists. Intervention: Web-based survey. Main Outcome Measure: Respondents' indication of strong agreement with questionnaire statements (selecting 8, 9, or 10 on a 10-point scale). Results: The survey found that 75% and 61% of pharmacists believed strongly that CHD and high blood cholesterol levels, respectively, are significant health problems facing Americans, and 60% believed that not enough is currently being done to reduce this risk. Pharmacists indicated that they very regularly advised patients about prescription and nonprescription treatments (75%) and encouraged adherence to them (78%); a smaller but substantial proportion regularly monitored patient response to prescription (33%) and nonprescription therapies (15%) and provided point-of-care cholesterol testing (7%). The survey also revealed that the majority of pharmacists (68%) would support consumers interested in purchasing a nonprescription statin product and 82% believed such a product would be more effective than currently available cholesterol-lowering dietary supplements. Pharmacists were concerned that patients pursuing nonprescription statins might discontinue their prescription cholesterol-lowering medications (79%), experience adverse effects (79%), and not be able to self-manage their use of a nonprescription statin product (78%). Conclusion: Community pharmacist members of APhA believe that CHD and cholesterol are important problems facing many people, routinely provide services that support patients who wish to self-administer nonprescription therapies, and would be interested in supporting consumers who wish to carry out therapy with a nonprescription statin.