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Item A cross-sector, multidisciplinary approach to lipid optimisation(Elsevier, 2023-12-16) Jones, Marcus; Balasubramani, Mathangi; Bhargava, Kieron; Braybrook, Saran; Richards, David; Gibbons, Rachel; Suleiman, Ziad; Turner, Helen; Gan, Kok-Swee; Jones, Marcus; Balasubramani, Mathangi; Bhargava, Kieron; Braybrook, Saran; Richards, David; Suleiman, Ziad; Turner, Helen; Gan, Kwok-Swee; Additional Professional Scientific and Technical; Medical and DentalIntroduction: The aim of this quality improvement study was to identify patients with cardiovascular disease (CVD) and suboptimal lipid profiles, and use pharmacist independent prescribers to optimise their cholesterol lowering medication, in line with a locally developed treatment pathway, to achieve NICE recommended lipid targets. Methods: Five pharmacist prescribers, from both primary and secondary care backgrounds, undertook one session per week at five Gloucestershire GP practices. Patients aged 18 to 75 years, with documented CVD and non-high density lipoprotein cholesterol (non-HDLc) ≥2.5mmol/L, were identified by searching electronic patient records. A lipid optimisation treatment pathway was developed by the secondary care lipid clinic and used by the pharmacists to conduct telephone-based lipid consultations, order blood tests and optimise lipid treatment over a 9-month period (September 2021 to May 2022). Results: 937 patients were identified by the initial search criteria and 635 patients’ clinical records were reviewed, of which 527 patients (83%) were shown to be correctly identified and appropriate for lipid optimisation. Of the 527 patients who met the inclusion criteria, 516 patients (98%) received a telephone consultation. Treatment was amended in 374 patients (71%) and secondary care referral / advice was sought for 18 patients (3%). Of the 374 patients whose treatment was amended, 269 patients (72%) had a measured reduction in cholesterol and 138 patients (37%) achieved a non-HDLc <2.5mmol/L during the study period. At the end of the study, 133 patients (36%) were either awaiting blood test results or required further medicine optimisation. Conclusions: In a stretched primary care sector, this study demonstrated that pharmacist prescribers from both primary and secondary care backgrounds were able to follow a lipid optimisation pathway to achieve measured cholesterol reductions in patients with CVD. The study treatment pathway, which was developed and trialled through primary and secondary care joint-working, has subsequently been endorsed and made available across the Gloucestershire Integrated Care System. This, and the ongoing education sessions provided by the project group for the Gloucestershire primary care networks, has helped to raise awareness and update knowledge of lipid treatments and targets.