Cholesterol screening

Madejski RM, Madejski TJ. 1996. Cholesterol screening in a community pharmacy. J Am Pharm Assoc AS3S 243. 

As pharmacy practice evolves from a product to a patient orientation, there are unique challenges that arise in managing the value-added services that pharmacists are developing to meet patient needs (e.g., cholesterol screening, diabetes education, drug therapy monitoring, etc.). A section of this book is dedicated to the planning, implementation, reimbursement and evaluation of these new patient care services offered by pharmacists. 

E301 Warnick, G.R., Lum, C., Walden, C. and Knopp, R.H. (1986). Evaluation of portable analyzers for lipid analysis with emphasis on cholesterol screening. Poster presented at IXth Int. Symp. Drugs Affecting Lipid Metabolism, Florence, Italy, 22 October. 

E617 Greenland, P., Bowley, N.L., French, C.A., Meiklejohn, B., Gagliano, S. and Sparks, C.E. (1990). Precision and accuracy of a portable blood analyzer system during cholesterol screening. Am. J. Public Health 80,181-184. 

R163 Bachorik, P.S., Rock, R., Cloey, T., Treclak, E., Becker, D. and Sigmund, W. (1990). Cholesterol screening Comparative evaluation of on-site and laboratory-based measurements. Clin. Chem. 36, 255-260. 

RI69 Bradford, R.H., Bachorik, P.S., Roberts, R., Williams, O.D. and Gotto, A.M. (1990). Blood cholesterol screening in several environments using a portable dry-chemistry analyzer and flngerstick blood samples. Am. J. Cardiol. 65, 6-13. RI70 Braidwood, J.L. (1990). Laboratory testing closer to the patient The Canadian scene. Med. Lab. Sci. 47, 312-318. 

R189 Miller, W.G. and Bowie, J.V. (1990). Standardization of cholesterol screening in Virginia. Clin. Chem. 36, 965, Abstr. 65. 

As discussed earlier, cholesterol screening is currently recommended for all adults in the United States. However, for children such a screening program remains highly controversial. According to the NCEP and the American Academy of Pediatrics, only children over the age of 2 should be screened for hypercholesterolemia when they have a parent with hypercholesterolemia (>240 mg/dL) or a positive family history (mother, father, uncle, aunt, or grandparent) with early documented CHD (at 55 years or less), myocardial infarction, angina pectoris, peripheral vascular disease, cerebrovascular disease, or sudden cardiac death. Several studies, however, have demonstrated the weakness of... 

Dennison BA, Kikuchi DA, Srinivasan SR, Webber LS, Berenson GS. Serum total cholesterol screening for the detection of elevated low-density lipoprotein in children and adolescents the Bogalusa Heart Study. Pediatrics 1990 85 472-9. 

Ridker PM, Stampfer MJ, et al. Novel risk factors for systemic atherosclerosis a comparison of C-reactive protein, fibrinogen, homocysteine, lipoprotein (a), and standard cholesterol screening as predictors of peripheral arterial disease. JAMA 2001 285 2481-5. 

Rifai N, Neufeld E, Ahlstrom P, Rimm E, D Angelo L, Hicks JM. Failure of current guidelines for cholesterol screening in urban African-American adolescents. Pediatrics 1996 98 383-8. 

McKcnney, J.M. An evaluation of cholesterol screening in community pharmacies. Am. Pharm. 1993, NS33, 34-40. 

A 49-year-old female presents to your clinic for follow-up after initiating a new medication (lovastatin) for her elevated cholesterol. She is currently without complaints and is feeling well. On repeat serum cholesterol screening, there is noted to be a decrease in the cholesterol level. The patient asks if she needs to continue the medication and what the potential side effects and benefits might be. Her physician explains that this medication inhibits the rate-limiting step and key enzyme in cholesterol biosynthesis. 

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