Home' Australian Pharmacist : Australian Pharmacist January 2016 Contents Australian Pharmacist January 2016 I ©Pharmaceutical Society of Australia Ltd.
CONTINUING PROFESSIONAL DEVELOPMENT
In conclusion, pharmacists can play
an important role with CVD screening.
To achieve this, we must deliver
screening in the context of absolute risk
rather than individual risk factors, and
must ensure a coordinated approach
with GPs and other stakeholders.
1. Australian Institute of Health and Welfare. Cardiovascular
disease mortality: trends at different ages. Cardiovascular
disease series no. 31. Cat. no. CVD 47. Canberra: AIHW; 2010.
2. Yusuf S, Hawken S, Ounpuu S, et al. Effect of potentially
modifiable risk factors associated with myocardial infarction
in 52 countries (the INTERHEART study): case-control study.
3. Australian Institute of Health and Welfare. Prevention
of cardiovascular disease, diabetes and chronic kidney
disease: targeting risk factors. Cat. no. PHE 118. Canberra:
AIHW; 2009. At: www.aihw.gov.au/publication-
4. Banks E, Crouch S, Korda R, et al. Absolute cardiovascular
disease risk and treatment in the general Australian
population: preliminary results. In: Chronic disease risk
factors & prevention. Hobart, Australia: Population Health
5. Willis A, Rivers P, Gray LJ, et al. The effectiveness of screening
for diabetes and cardiovascular disease risk factors in a
community pharmacy setting. PLoS One 2014;9(4):e91157.
6. National Vascular Disease Prevention Alliance. Guidelines
for the management of absolute cardiovascular disease risk.
Canberra: National Stroke Foundation; 2012.
7. Kilkenny MF, Johnson R, Andrew NE, et al. Comparison of two
methods for assessing diabetes risk in a pharmacy setting in
Australia. BMC Public Health 2014;14:1227.
8. Lowres N, Neubeck L, Salkeld G, et al. Feasibility and cost-
effectiveness of stroke prevention through community
screening for atrial fibrillation using iPhone ECG in
pharmacies. The SEARCH-AF study. Thromb Haemost
9. Boulware L, Jaar BG, Tarver-Carr ME, et al. Screening for
proteinuria in US adults: a cost-effectiveness analysis. JAMA
10. Johnson DW, Jones GR, Mathew TH, et al. Australasian
proteinuria consensus working group. Chronic kidney
disease and measurement of albuminuria or proteinuria: a
position statement. Med J Aust 2012;197(4):224–5 .
11. Kaczorowski J, Chambers LW, Dolovich L, et al. Improving
cardiovascular health at population level: 39 community
cluster randomised trial of cardiovascular health awareness
program (CHAP). BMJ 2011;342:d442.
12. McNamara K, Dunbar JA, Krass I, et al. Absolute risk screening
in pharmacy: report to the Heart Foundation; 2015.
13. Glasgow RE, Emont S, Miller DC. Assessing delivery of the
five ‘As’ for patient-centered counseling. Health Promot Int
14. Sabater-Hernández D, De La Sierra A, Sánchez-Villegas
P,et al. MEPAFAR study workgroup. Agreement between
community pharmacy and ambulatory and home blood
pressure measurement methods to assess the effectiveness
of antihypertensive treatment: the MEPAFAR Study. J Clin
Hypertens (Greenwich) 2012;14(4):236–44 .
15. Langsted A, Freiberg JJ, Nordestgaard BG. Fasting and
nonfasting lipid levels: influence of normal food intake on
lipids, lipoproteins, apolipoproteins, and cardiovascular risk
prediction. Circ 2008;118(20):2047–56.
16. Craig SR, Amin RV, Russell DW, et al. Blood cholesterol
screening influence of fasting state on cholesterol results and
management decisions. J Gen Intern Med 2000;15(6):395–9 .
17. Wilder LB, Bachorik PS, Finney CA, et al. The effect of fasting
status on the determination of low-density and high-density
lipoprotein cholesterol. Am J Med 1995;99(4):374–7 .
18. Ridker PM. Fasting versus nonfasting triglycerides and the
prediction of cardiovascular risk: do we need to revisit the
oral triglyceride tolerance test? Clin Chem 2008;54(1):11–13.
19. Kuo CY, Hsu CT, Ho CS, et al. Accuracy and precision
evaluation of seven self-monitoring blood glucose systems.
Diabetes Technol Ther 2011;13(5):596–600 .
20. Royal Australian College of General Practitioners. Guidelines
for preventive activities in general practice. 8th edn. East
Melbourne: RACGP; 2012. At: www.racgp.org.au/your-
1. Which ONE of the following BEST
describes the population that
national guidelines recommend
should be targeted for absolute risk
assessment in Australia?
a) All adults aged 18 years or over.
b) Males aged 35 years or more, females
aged 45 years or more.
c) All adults aged 45 years or more
(35 years or more if Aboriginal or Torres
Strait Islander) without a prior diagnosis
d) All adults aged 45 years or more
(35 years or more if Aboriginal or Torres
Strait Islander), regardless of CVD history.
e) Individuals from any ethnic group
considered to have a higher risk than
the general population.
2. Which proportion of Australian
adults aged 45–74 years are
estimated to be at moderate-to-
high risk of CVD but not receiving
recommended drug treatments?
3. Ahmed is estimated to have an
absolute risk score of 12%. This was
attributed to elevated blood pressure
(165 mmHg systolic BP). Under which
of the following circumstances might
drug therapy for hypertension or
lipids be considered?
a) If initial attempts with lifestyle
modification for 3–6 months have
shown no improvement in risk.
b) If systolic blood pressure remains at
165 mmHg for the subsequent six
c) If Ahmed has a family history of CVD.
d) If Ahmed was born in the Middle East.
e) Any of the above.
4. Joanna, a 77-year-old female, has
come to your pharmacy asking for a
CVD risk screening. She has no history
of diabetes or CVD but is aware that
her increasing age is likely to increase
her CVD risk. Is it appropriate to
conduct an absolute risk assessment
for Joanna (and why)?
a) No – only adults aged 45–74 years
should be screened.
b) No – Joanna is automatically considered
at high risk of CVD because of her age.
c) Yes – her age should be considered
74 years if conducting an online
assessment, and she should be made
aware of a likely underestimate of risk.
d) Yes – but you should use lipid pathology
results from when she was 74 years of
age and using current point-of-care
tests would be invalid.
e) No – at Joanna’s age it is more
important to test for AF and kidney
function as these are the most likely
factors to cause CVD.
5. Which ONE of the following
statements is BEST regarding the
absolute risk screening process?
a) For an accurate absolute risk score,
fasting lipid levels must be used.
b) Proteinurea testing is most likely to be
cost-effective if directed towards high-
risk individuals and linked to treatments.
c) Proteinurea testing is the gold-standard
process for diagnosis of CKD.
d) It is a pointless and unnecessary to
assess CVD risk factors such as kidney
function during screening that are not
necessary for estimation of absolute risk
e) Patients should have their absolute risk
re-assessed every five years.
Links Archive Australian Pharmacist December 2015 Australian Pharmacist February 2016 Navigation Previous Page Next Page