PSHP 2026 Residency Conference

Purpose:
The purpose of this study was to compare the number of patients who had appropriate lipid panel follow-up/monitoring at TUHS divided by management type: managed by pharmacy (Rx-managed) and not managed by pharmacy (Non-Rx-managed).


Methods:
This study was conducted at the Temple Internal Medicine Associates (TIMA) clinic at TUHS from 07/01/2024 to 06/30/2025. Inclusion criteria were age ≥18 years, TIMA patients, ≥2 in-person visits (≥3 months apart), and ≥1 lipid panel during the study period. Exclusion criteria included ESRD, palliative care, pregnancy, TSH >4.5 mIU/L, or TG >400 mg/dL. Patients were categorized as Rx-managed (≥2 pharmacist visits) or Non-Rx-managed (managed exclusively by non-pharmacist clinicians). The primary endpoint was the number of lipid panels. Secondary endpoints included mean LDL-C, number of patients achieving LDL-C <100 mg/dL and <70 mg/dL, and number of patients receiving lipid-lowering therapy. Due to group size differences, 1:4 propensity score matching was performed using age, sex, race, T2DM, and ASCVD. Continuous variables were analyzed using the Wilcoxon rank-sum test, and categorical variables using Fisher’s exact or Chi-square tests.


Results:
Baseline characteristics were similar between groups after 1:4 matching. A greater proportion of patients in the Rx-managed group had more than one lipid panel compared with the Non-Rx-managed group (39.7% vs 27.1%, p=0.006). Mean LDL-C was numerically lower in the Rx-managed group (86.6 vs 88.4 mg/dL), though not statistically significant. The proportion of patients achieving LDL-C goals was similar between Non-Rx-managed and Rx-managed groups (<100 mg/dL: 67.1% vs 70.2%; <70 mg/dL: 34.3% vs 38.8%). Use of lipid-lowering therapy was comparable between groups. This study used real-world data and propensity matching to improve comparability; however, it was limited by its retrospective, single-center design and lack of baseline lipid values.


Conclusion: 
Patients in the Rx-managed group were more likely to receive additional lipid monitoring than those in the non-Rx- managed group. Although not statistically significant, the Rx-managed group showed trends toward lower LDL-C and greater goal attainment. Future studies with longer follow-up and baseline lipid values are needed to better evaluate longitudinal lipid outcomes and the clinical impact of pharmacist-led management in lipid management.