Cardiovascular risk assessments conducted in community pharmacy

Abstract

Background: Cardiovascular disease (CVD) is the second most common cause of premature deaths in England, further driven by health inequalities. People from deprived areas are four times more likely to die prematurely compared to people in more affluent areas. In North-East London (NEL) 130,000 people are living with heart and circulatory diseases that is claiming 220 lives monthly. People with high cholesterol who also have other risk factors (e.g. high blood pressure, diabetes, smoking) are at significantly greater risk of CVD, commonly asymptomatic, and have most to gain from a reduction in cholesterol. Objective(s): The objective of this study is a service evaluation of conducting cardiovascular risk assessments in community pharmacy, focusing on addressing health inequalities and improving patient experience. The hypothesis is to identify people early, within the underserved communities, at risk of CVD, providing excellent experience. Method(s): A community pharmacy was selected, to undertake opportunistic CVD risk assessments, in an area with the greatest deprivation in the UK. The pharmacy professionals conducted cholesterol point of care tests, blood pressure tests, measured height and weight to calculate the CVD risk using QRISK3. Each of these parameters were collected alongside patient demographics, including Index of Multiple Deprivation (IMD) and ethnicity. Feedback from people being tested, was captured using a survey, specifically on accessibility and acceptability. Culturally relevant lifestyle advice was offered to all. Referral to general practice (GP) was made for people with a QRISK3 of 10% or more, recommending initiation of lipid lowering therapy. Result(s): A total of 44 people had their CVD risk assessment conducted over six weeks from 23/01/25. The mean age was 49 years; 17 (39%) were male; five (11%) were smokers; 31 (70%) lived in the 20% most deprived areas and 35 (80%) were from global majority ethnicities. The average blood pressure was 127/84mmHg and average body mass index of (BMI) of 30kg/m2. Nine (20%) people had a QRISK3 of more than 10% and were referred to their GP for statin initiation. of these individuals, eight (89%) were from 20% most deprived areas and seven (78%) were from global majority ethnicities. Six people responded to the survey. All respondents rated their experience as 'Excellent' or 'Good', wanting to recommend the service to family and friends. The service was praised for convenience, saving time compared to traditional GP appointments and quality of care. One respondent stated, 'the time saved is invaluable'. Conclusion(s): Given the rising burden of CVD, there is a need to develop innovative services to enable earlier prevention strategies. Conducting CVD risk assessments in community pharmacy is effective in identifying people early. In addition, this setting enables people from underserved communities to be identified for CVD risk, reducing health inequalities. People were positive in their experience of this service. Community pharmacy is an acceptable setting to conduct opportunistic CVD risk assessments and is viewed as easily accessible. By facilitating immediate tests, there is a reduction in delays to clinical decisions..