Demonstration of community pharmacy and managed care organization collaboration on cardiovascular disease risk factor identification using health risk appraisal

Objective: To integrate the resources from a local statewide managed care organization (MCO) and a supermarket pharmacy chain to conduct a comprehensive health risk appraisal (HRA). Collected data were used to assess cardiovascular risk factors and identify disease management opportunities. Methods: An analysis to determine the prevalence of risk factors was conducted on a cross-sectional HRA survey. The HRA involved point-of-care cholesterol screening (with a follow-up risk factor questionnaire) conducted by pharmacist employees of the employer group (a regional supermarket chain). Those eligible for the screening were employees of the supermarket chain and their dependents covered by the participating MCO. Results: A total of 12,915 completed HRA questionnaires were received. The mean age of the employees participating was approximately 44 years. Of note, 14%, 24%, 21%, and 69% of questionnaires had abnormal values for total cholesterol, high-density lipoprotein (HDL) cholesterol, blood pressure, and body mass index (BMI), respectively. Compared with national benchmarks, low HDL cholesterol and BMI more than 30 kg/m(2) were more common in this cohort. More than one-fourth of the employees in this analysis were identified as being at high risk for a coronary heart disease event. Conclusion: The unique collaboration presented here allowed for an expanded role of pharmacists to implement a quality improvement program. In response, the employer decided to continue the HRA screening and offer a employee contribution reduction-based health incentive to covered members. The employer also is considering offering cardiovascular disease management interventions that will be performed by the supermarket chain's pharmacists and targeted toward the identified risk factor trends.