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Veterans Affairs Medical Center (VAMC)
Memphis, Tennessee
Purpose: This study explored whether pharmacist management of chronic pain results in subsequent improvements in markers of hypertension, hyperlipidemia and diabetes mellitus.
Methods: Medical records of 66 veterans attending a pharmacist-run ambulatory pain clinic between August 1, 2010 and March 31, 2012 were reviewed. Baseline and post-pain clinic data collected included blood pressures, A1c, lipid panels, pain scores, weight, and BMI. Medication compliance was also assessed pre and post interventions by pain clinic pharmacist. Deviations from baseline values were analyzed using a student’s paired t test and McNemar’s test.
Results: Reductions in systolic blood pressure (134 ± 12 vs. 130 ± 13, p=0.03), diastolic blood pressure (78 ± 8 vs. 76 ± 7, p=0.04), total cholesterol (202 ± 53 vs. 184 ± 56, p=0.009), LDL cholesterol (122 ± 48 vs. 105 ± 42, p=0.008), and pain scores (7.2 ± 1.8 vs. 6.6 ± 2.4, p=0.009) following pain management by a clinical pharmacist were statistically significant. Reductions in A1c, triglycerides, weight, and BMI were not statistically significant nor was change in HDL cholesterol. Medication compliance increased post pain clinic, with the increases in medication compliance for hypertension (75% vs. 91%, p=0.04) and hyperlipidemia (61% vs. 86%, p=0.001) being statistically significant.
Conclusions: This study is one of the first to demonstrate the positive impact of pain management by a clinical pharmacist on chronic disease states. While increased medication compliance likely played a significant role in reducing blood pressure and improving cholesterol management, other contributing factors likely played a part. More studies with a larger sample size are needed to determine if pain management by a clinical pharmacist results in significant changes in A1c.