Employer-Sponsored Wellness Programs for Hypertension and Dyslipidemia in a 2-Hospital Health System.

Abstract

Background: The increasing prevalence of chronic disease states, such as hypertension and dyslipidemia, in the United States has placed a growing economic burden on the nation's healthcare system, and incentives for cost reductions have been used by various private health insurers.

Objective: To analyze the clinical outcomes of pharmacy department-managed, employer-sponsored wellness programs for dyslipidemia and hypertension in a 2-hospital health system.

Methods: Using a retrospective chart review, we evaluated outcomes of employees and their spouses who were enrolled in our dyslipidemia and hypertension Wellpath programs between November 2015 and April 2017. Employees or their spouses were referred to these programs, which were coordinated by the pharmacy department. Enrollees completed in-person appointments and telephone interviews with a pharmacist or an advanced practice nurse, who provided evidence-based lifestyle and pharmacologic recommendations. The primary outcomes were lipid changes in the dyslipidemia program, and changes in systolic or diastolic blood pressure in the hypertension program. The secondary outcome was the total number of pharmacologic interventions. Paired sample t-tests were used to assess the results.

Results: A total of 138 enrollees met the study inclusion criteria. The mean difference in systolic and diastolic blood pressure between baseline and completion of the program was -8.33 mm Hg (P = .001; 95% confidence interval [CI], 3.58-13.09) and -3.67 mm Hg (P = .015; 95% CI, 0.75-6.58), respectively. The mean differences in total cholesterol, low-density lipoprotein, and triglycerides from baseline were -27.67 mg/dL (P <.001; 95% CI, 19.36-35.99), -23.16 mg/dL (P <.001; 95% CI, 15.41-30.92), and -67.62 mg/dL (P <.001; 95% CI, 30.73-104.52), respectively. In all, 46 (46.9%) of the 98 enrollees in the dyslipidemia program required a pharmacologic intervention. In the hypertension program, 18 (31.6%) of 57 enrollees required a pharmacologic intervention.

Conclusion: Our findings demonstrate that the use of a pharmacy department-managed, employer-sponsored wellness program that is managed by pharmacists and an advanced practice nurse could lead to significant reductions in blood pressure and lipid levels for employees and for their spouses who are enrolled in the program.