CEimpact Podcast

Pharmacist-Driven Dyslipidemia Management

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Dyslipidemia remains a major contributor to cardiovascular disease, and pharmacists play a key role in optimizing therapy and improving outcomes. This episode reviews recent updates in guidelines, pharmacologic options, and practical counseling tips for supporting patients with lipid disorders. Tune in to strengthen your clinical impact and support long-term health for the patients you serve.

HOST
Joshua Davis Kinsey, PharmD
VP, Education
CEimpact

GUEST
Janelle Ruisiner, PharmD, FAPhA
Clinical Professor
The University of Kansas School of Pharmacy

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CPE INFORMATION
Learning Objectives
Upon successful completion of this knowledge-based activity, participants should be able to:
1. Describe current guidelines and evidence-based pharmacologic options for managing dyslipidemia.
2. Identify key counseling strategies pharmacists can use to support adherence and improve lipid-related outcomes.

0.05 CEU/0.5 Hr
UAN: 0107-0000-25-226-H01-P
Initial release date: 6/30/2025
Expiration date: 6/30/2026
Additional CPE details can be found here.

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Speaker 1:

Hey, ce Impact subscribers, Welcome to the Game Changers Clinical Conversations podcast. I'm your host, josh Kinsey, and as always, I'm excited about our conversation today. Dyslipidemia is a major contributor to cardiovascular disease, yet gaps in treatment and adherence remain common. In this episode, we'll review current guidelines, therapeutic updates and how pharmacists can help patients achieve better lipid control and better long-term cardiovascular health. I am very, very excited to have a good friend and colleague with us today, janelle Ruesinger. Janelle, thank you, it's so good to see you.

Speaker 2:

My pleasure. I'm happy to be here.

Speaker 1:

So Janelle and I go back. Gosh, been almost five years now, right, or more, yeah. So I had the great pleasure of getting to know Janelle when we lived in Kansas recently and got to work with her for a few months and just stayed friends and colleagues and just super excited. As soon as this topic came up, I knew she was who I wanted to speak on this. This is her passion, her love. So again, thank you. I know it's busy time. I remember from academia people always said oh, it's the summer, it's easy peasy and it's actually harder most of the time. So I know it's a busy, busy time. So thanks for giving us your afternoon. So, janelle, for our listeners. So, janelle for our listeners, since they're not as privileged as I, they don't know you that well maybe. So go ahead and tell us a little bit about yourself and your practice side and all that good stuff.

Speaker 2:

Sure. So I am a clinical professor in the Department of Pharmacy Practice at the University of Kansas School of Pharmacy. I'm also currently the Associate Dean for Academic Affairs within the school. My practice site was the Atherosclerosis and lipid apheresis center at the University of Kansas Medical Center. So I did that for over 20 years, focused on lipids, was able to have residents, pharmacy residents in that clinic.

Speaker 2:

There were two of us pharmacists in there and then we worked under protocol with Dr Patrick Moriarty, who is a physician and well-known in the lipid world. So I was very fortunate to be able to learn a lot from him in the 20 plus years of being there. Our clinic at the medical center we kind of saw the worst of the worst. It was a referral clinic, so patients were sent to us if they couldn't tolerate a statin or if they had multiple events on statins or had familial hypercholesterolemia or had high lipoprotein A, if they couldn't tolerate a statin, or if they had multiple events on statins or had familial hypercholesterolemia or had high lipoprotein A if they needed a lipid apheresis, which is a really interesting topic in itself. So yeah, learned a lot and had a great time in there.

Speaker 1:

That's great and the clinic name is such a mouthful.

Speaker 2:

Did y'all ever?

Speaker 1:

give it a quick little moniker that you could use, or did you always say that?

Speaker 2:

We always said that we never ended up giving it an acronym or anything like that. A lot of times we would just be referred to as the Lipid Clinic.

Speaker 1:

Yeah, I was just going to say the clinic is probably what I would have done. So, yeah, it's funny because we pharmacists, people, we love our acronyms, so it's interesting that you never gave it a big acronym so well. Again, thank you so much, chanel, so good to see you and thrilled to have you on our episode today. So, without further ado, let's jump in, let's get started on our topic for today. So again, our topic for today is dyslipidemia and, as always, I like to just kind of set the groundwork and make sure everybody's on the same page. So, if you want to take just a minute or two to kind of remind us what dyslipidemia means, what it involves and just kind of how it plays a role in cardiovascular risk and health, Sure, sure.

Speaker 2:

So dyslipidemia is kind of a broad term that can encompass a lot of different types of changes or issues in cholesterol. So you can have mixed dysplidemia, where you have high LDL and high triglycerides. You can have only high LDL, you may have low HDL, you may have familial hypercholesterolemia, which means you have very high levels of LDL, that you because of a genetic mutation and so kind of a broad term. And so one of the reasons why, or you know a reason why that's a problem is cardiovascular disease is still the number one cause of death in the United States and a big contributor of that is the cholesterol or the high cholesterol levels. So where that plaque formation then can lead to heart attack, to stroke, to needing a bypass, to stents and a whole host of problems, and so addressing that, staying on top of it, being involved, educating our patients, is really important and hopefully we can knock that down from the leading cause one of these days, but it has been there for a long time.

Speaker 1:

Yeah, I know you would think, I mean you would think cancer would have eventually taken it over, but I think it's just. I mean, like you said, it's just such a juggernaut. So, remind us again, just I always, like I said, like to just lay the foundation. The big three that we think of are LDL, hdl and triglycerides. And just to remind us again, ldl is considered the bad one, so we want that, we don't want that to be high. Hdl is the good one and we want to be sure that we're getting that as high as possible, right. And then our triglycerides are also another one of the bad ones that we want to try to keep on the lower end of things as well. And triglycerides everything can be affected by diet, but correct me if I'm wrong triglycerides are more of one of those that are really affected by the diet, correct?

Speaker 2:

Yes, definitely. So a couple of things I always like to tell patients. Ldl is the lousy cholesterol. You want low. Hdl is the helper cholesterol. You want high, right. And then the triglycerides you're right, can largely be affected by diet and exercise. A few instances where, again, is a genetic component to it, but for the majority of the population, exercise and diet and weight loss can certainly bring those down.

Speaker 1:

Help out with those. Yep, okay, and another one you mentioned. Well, before we get into that, I'll segue. Well, no, let's segue into it now. So you mentioned lipoprotein A. So that's gotten a lot of press recently, so let's talk briefly about that really quick, and then we'll jump back to the other prevalence of dyslipidemia and everything. So, while we're on that subject, let's talk about lipoprotein A real quick, okay.

Speaker 2:

Well, I could talk about that, probably the entire podcast alone, so you can give me the signal that I need to wrap it up here pretty soon. Lipoprotein A has been a passion of Dr Moriarty, so the physician I worked under in the 20 plus years that we worked with him he has worked tirelessly to try to get it more attention, to get people to pay attention to it. It's another component of your cholesterol but it's hereditary, so by the time you're about age five your level is stable and so it's not routinely checked. So when you do a lipid profile it doesn't come along with the LDL, hdl triglycerides, it's a separate test. But the problem is it is atherogenic in most instances, so very similar to LDL in that it can cause put you at increased risk for heart attacks, for strokes, it can put you at risk for valvular disease, and the problem with it is that you could literally eat twigs and berries and not change this level again because of the genetic component.

Speaker 2:

And the other challenge is we don't really have any agents right now that can lower lipoprotein A. The PCSK9 inhibitors can maybe lower it about 25%. I mentioned that lipid apheresis, so in extreme cases, patients who use that it will lower lipoprotein A significantly. But right now we don't have anything to lower that. The good news is we've got a couple of agents that are in trials right now, and so the one agent can lower lipoprotein A by about 94%, and so we're very excited about that. Interestingly, the European guidelines recommend the European lipid guidelines recommend that every person get that tested. Once the US guidelines haven't quite got there yet, we recommend it more in patients that are high risk or have had multiple events, have had family history, significant family history and things like that. So, but I think you're going to be hearing a lot more about lipoprotein A in the near future.

Speaker 1:

Yeah, and I think I mean it makes sense that if and when those drugs come to fruition and they actually enter the market and get approved, I feel like then if there's something to treat it, hopefully the attention it'll get the attention it needs by being tested, because then because I mean I'm not on that side of why test it, you're not going to be able to do anything with it, but I'm sure that's what people think is like, well, what's the point? And if it's high or low we can't do anything about it. So hopefully with the new medications in that class, that would be beneficial. Do you know and I may be putting you on the spot, sorry Do you know if those new medications also affect LDL? Do they do anything else, or are they targeting solely lipoprotein A?

Speaker 2:

They're targeting solely lipoprotein A, from what I'm understanding, but the good news is they're looking for outcomes they want. We have had agents in the past that lowered LDL levels and things like that, but didn't improve outcomes, and so they're looking for some outcomes data for these. So it might be hopefully in the next five years maybe we'll see something come out for sure.

Speaker 1:

Yeah, that'd be great. Okay, well, thank you, that was just. It seemed like a good segue when we were talking about the components and I know that that one has been in the news a lot lately because of these studies and just in general. So hopefully Dr Morati is, he's finally getting his wish and it's kind of yeah, it's kind of coming more mainstream. So what let's let's back up just real briefly and just talk about the prevalence of dyslipidemia and its impact on public health in general, because I mean it can be a very costly disease if it obviously feeds into cardiovascular issues and what's the importance of early detection. So let's talk about that for a little bit.

Speaker 2:

Sure. So it looks like about 11% of adults that are age 20 or older have high cholesterol levels, and so early identification is important, because the sooner you address it, hopefully you're putting off any chance of an event down the road. Now dyslipidemia is a little bit frustrating, right, because it's a slow process and patients don't feel any different whether their cholesterol levels are high or whether they're low, and so it's very easy for people to put off getting that cholesterol checked, despite maybe a significant family history or maybe despite diabetes or, you know, being overweight or anything like that. But we know that the earlier we can bring those cholesterol levels down and address those risk factors, the better off we are as far as preventing those events down the road.

Speaker 1:

Right, yeah, and that's a good point, because you think about someone who has diabetes. They usually they feel different with low or high. It's easy to say like, oh, I need to get that under control because it makes me feel terrible or whatever. So it's an interesting point that because we don't feel a certain way with our levels of lipids, it's hard to say like, well, you'd feel better if you got it under control, because it's not really the case. So you'd feel better mentally and emotionally, hopefully.

Speaker 1:

But, yeah, it's hard to kind of relay that to patients sometimes. What remind us about? Like if you find out that you have high levels and you getting them under control, whether you go on medication or whether you lose weight or start exercising whatever, can any of the damage that's been done so, like plaque buildup or whatever? Can that be reversed? Are there? Are there benefits for that as well?

Speaker 2:

Sure, sure. And so what you're, once you know that plaque is laid down, sure, sure. And so what you're, once you know that plaque is laid down, what you want to do is stabilize it. So you want it to basically calcify, and it will do that over time if you bring down that cholesterol level. And so you, you may see a little bit of regression, but for it to completely go away is probably not the case, and once it's calcified, it's going to stay there. One thing that we would look at is a carotid IMT kind of getting off subject here, but it's where we were looking at. It's an ultrasound where you look at non-calcified plaque and we could actually, if we brought levels down, we could show regression in that non calcified plaque. And so, yeah, you, you can it may not, you know, completely clean out the right, the arteries, but you're, you're, you're allowing it to stabilize, which then doesn't usually rupture, and then you're keeping it from getting larger.

Speaker 1:

Exactly exactly. Just try and think of more beneficial talking points to convince a patient, you know, to do this or whatever. So, yeah, okay, that's great. So let's touch on really briefly. I'll just kind of mention some of the things that we're going to dig into deeper. But lots of opportunities for pharmacists and I feel like I say that with every subject that we tackle on this on this podcast but there's just, there's so many opportunities. So, because we're so accessible and because we're knowledgeable and we have this training.

Speaker 1:

But you know, some of the things we're going to talk about and really dig into is medication optimization, lifestyle counseling, and that includes diet, exercise, you know, supplements, things like that, and as well as just education in general about the disease, about the fact that it's a stepping stone to something bigger. It's not just oh, okay, fine, I'll just have high LDL. No, that could lead to cardiovascular disease, that could lead to future complications, heart attack, et cetera, et cetera, so, yeah, so really just touching on the fact that education that we provide as pharmacists is also critical. So with that, let's jump into one of the first things, and that is helping with medication optimization. But that requires us to stay updated on the medications and the guidelines. So if you'll tell us a little bit about, maybe, how often the guidelines come out and why it's important to stay up to date on those and things like that, Sure, sure.

Speaker 2:

So the current guidelines are from 2018, the American Heart Association, american College of Cardiology and the whole host of other groups that endorsed them in CUPE, including the American Pharmacists Association.

Speaker 2:

There, we are hoping that maybe another guideline will come out in the next few years. We're kind of due, I think, especially looking at some of the data that we're getting from maybe some of these newer drugs that might be coming out. I'm hopeful that something will be coming out before too long, but I don't think anything official has been actually announced. Yeah, I think kind of the maybe I don't know frustrating or overwhelming piece of it is when you look at the guidelines themselves. They're what 40, 50 pages and the average person is. You know, I'm not going to read every minute, every word of the diabetes guidelines and the lipid guidelines and the hypertension guidelines, and so something that they implemented in the 2018 guidelines are the top 10 take-home messages and so yeah, and so I think, instead of maybe being overwhelmed by trying to look at that entire document, starting with simply those top 10 take home messages and ensuring that you are doing that and utilizing those to, we kind of teach here is take away some nuggets.

Speaker 1:

Like we know that it's impossible to know every single thing about every single thing, but you know taking home some of those pearls and some of those little nuggets, so I love that they did that with that iteration. I think that's just smart and I really hopefully others will continue to kind of take note of that, because again, it's kind of like what the CliffsNotes version of it you know. So it's, it's a good thing to kind of um, to also remind yourself of often, you know like to just look back at those and be reminded of things. So okay. So then, along those same lines, another thing that we can do as pharmacists is guide, therapy selection, dose optimization. So tell us a little bit about, maybe, some of the ways that that can kind of come into play, like when do we change the dose of something you know, if it's not responding or if they're having side effects, or you know that kind of thing. So if you can talk a little bit about our role in that space, that'd be great.

Speaker 2:

Sure, sure. And pharmacists, I think, have a really important role in that space. And so you know, if someone has not achieved that 50% reduction with their current statin you know, reduction of LDL with their current statin, are they on the maximum dose? Do we need to bump that up a little bit? Do we need to switch them to a statin that's maybe a little bit more potent? You know right to be a little bit. Do we need to switch them to a statin that's maybe a little bit more potent? You know right to be a little bit more aggressive with their therapy. Maybe they're already on the maximum dose of the current statin. Maybe we need to add a zetamide, but the patient doesn't want to add another medication and thinking about that, or even if they're on a zetamide and a statin, maybe it's time to have that conversation about the PCSK9 inhibitor.

Speaker 1:

Or maybe to have a conversation about adherence and make sure that they're actually taking their medication Exactly, exactly.

Speaker 2:

Right, or that there's not some side effect that's preventing them from, you know, from taking it. And so I think there are a lot of pieces. You know, a pharmacist doesn't even, I don't think, have to spend 30 minutes with the patient asking questions each time they come in, you know, to maybe glean some of that information can then guide some conversation, maybe a little bit longer conversations down the road, absolutely, yeah.

Speaker 1:

If there's one thing I'm learning with aging patients and aging parents and you know learning that process with them it's that you know sometimes they like to just play with their meds. Like you know, today I don't need it because I feel great and that's not really that's not really what should be happening.

Speaker 1:

So again, yeah, when you're seeing that the numbers are not adding up, what, what are all? I love that you laid out, like all the different scenarios, and then one of those also being you know, are you actually taking your med and if not, why? And if there's a reason why, can we also fix that you know? So, yeah, that's great. What about tell us what? Obviously statins and tell me we said this in the beginning, before we got on record, so I want you to repeat it because it's staggering Tell us the number of patients who never fill their statin prescriptions.

Speaker 2:

So about 50% of patients do not fill their prescription for their statin or they don't pick it up Right.

Speaker 1:

Right, they never even drop it off or whatever. Yeah, right, yeah.

Speaker 2:

Right. And so now, I think, with electronic transmission of prescriptions, pharmacists again are at a great point to say hey, miss Jones, I have this time here for you. Yeah, why? Why are you not picking this one up? Let's have a conversation about that.

Speaker 1:

You know what are your concerns.

Speaker 2:

Where are you getting your information? Are you getting it from Google? Let's maybe look at some, you know, point them in the direction of a few places they could get some good information, that's such a great point, janelle.

Speaker 1:

I love that because you know I think I've been in that space I know it's busy, the workflow is overwhelming and you can't always take note of everything. But when you see something like that, don't just assume oh well, they must have talked with their doctor and decided not to take it, or, oh, they must. Maybe they that particular one went mail order for some reason, or you know whatever. Like don't assume I love the. I love that because you're so right, like have that moment, even if it's two minutes, to be like, hey, why did you never pick this up? Do you have concerns? And I love your question of where are you getting your information? Because have concerns. And I love your question of where are you getting your information, because that's such a good one Because, again, they're probably getting misinformation, you know. So, yeah, that's such a great point.

Speaker 1:

Remind us what I was going for there. I wanted to share that because I think that that's just such I mean, it's just such a staggering number the percentage of people who actually just don't ever follow through, so that, in and of itself, if we get that under control, you know, that can help a lot. But remind us what medications are currently out Like. What are? What are some of the ones that we're going to see a lot of when we're treating dyslipidemia? What?

Speaker 1:

are the most common Sure.

Speaker 2:

So still kind of the foundation right are the statins, that entire class there. Then we have the phenofibric or the fibric acid derivatives. Not used as much, maybe because some of the data for some of the patients isn't as good, but you'll see that azetamide- is another one I think you're going to see.

Speaker 2:

You probably see a lot of Bambidoic acid is another one that came out a couple years ago and probably seeing it to some extent, and then the PCSK9 inhibitors. Those injectables are probably what you're going to be seeing as well are probably what you're going to be seeing as well.

Speaker 1:

Okay, and with the latter there, those are more reserved for severe cases, uncontrollable dyslipidemia Is that kind of what we're looking at with those Sure?

Speaker 2:

Yeah, yeah, I think they also have a place for those who are statin intolerant. You know, if you have someone who's high risk you know getting the myalgias from the statins, then you may see them uh as well. But they, the pcsg9 inhibitors, can most certainly be used in combination with the statins azetamide, you know, and some insurance companies are kind of requiring that that stuff. But you can still keep them on um those, those other agents.

Speaker 1:

Good to know. So we talked, we touched on this briefly, we talked about how, we talked about adherence and personal counseling and making sure that they're getting the right information and that they know what to do with that information. Medsync I think that's another thing that is important because that can help with adherence and that can make sure that they're picking it up along with their diabetes meds or whatever and just kind of keeping them on that cycle. But let's touch on briefly, before we kind of get into some of the challenges that we face. Let's talk about how we can promote lifestyle interventions and what should we be talking about and promoting in that space to our patients?

Speaker 2:

sure, sure, diet and exercise are foundational right and every patient, regardless of whether it's genetic, whether you know what the condition is, we should be promoting those lifestyle modifications. And you know, it kind of depends on the comfort level how much pharmacists want to get into that. Certainly, walking, we're not going to tell our 70 year old patient to start jogging right. So simply walking work, you know, working up slowly, because the other thing we see is if they're put on a statin and start exercising, they don't know if it's the exercise or the medication that's causing their muscle aches right, and so, if they haven't, exercised before they're going to have muscle aches.

Speaker 2:

And so, talking to them about that, the simple thing that we would say we had a dietician. We were fortunate to have a dietician in our clinic and she was absolutely fabulous, everyone saw her. But the simple thing that we would say to patients is it's simply calories in, calories out. Dr Moriarty would say if you're eating, if you would eat half of what you're eating right now it's mcdonald's every day right, if you ate half of that, you're going to lose weight, right, right and right. And so simply just being mindful of um, what um calories they're eating. And then, if they can make those small changes, right, instead of getting the french fries with your hamburger, maybe get a side salad or forego the fries all together and eat some fruit later on, or something like that. So you don't have to make a complete overhaul, but set some goals, make some small changes and start that way.

Speaker 1:

What about smoking and alcohol intake? Do those come into play? I mean, obviously they come into play everywhere, but are they big factors in dyslipidemia control?

Speaker 2:

Absolutely. So you know they say one drink a day, alcoholic drink a day is probably okay, but for someone with dyslipidemia, those again simply more calories that they're drinking and not getting a lot of nutritional value from, so being mindful of that. But specifically, if someone has high triglycerides, um asking about you know how much they're drinking each day, and and because alcohol can certainly um contribute to that, and again, you know reducing the amount if they say I, I must have um wine every night with dinner, that you know we can work with that. Just let's make sure it's not half a bottle, let's maybe do one four ounce serving, or you know something like that. And then with the smoking, yeah, that the smoking, you know they need to stop.

Speaker 2:

There are some different resources, even if you don't have a smoking cessation program at your pharmacy. You know some of the help lines and things like that. But the awesome thing too is that pharmacists can recommend you know some of the over the counter. You know nicotine replacement and so certainly options there. But yeah, the smoking, that that's a big one.

Speaker 1:

And I'll put a little shameless plug in here, because every time that we have other education available to you, there is a smoking cessation course that we have that you can check out in your profile and that can help you when you're talking with your patients and give guidance on recommendations and things like that too.

Speaker 1:

So, yeah, great, call out. Okay, let's jump into a little bit of the challenges that we may face as pharmacists in this space. So one of the things and we talked about this a little bit and when we're looking at you know optimization of the medications and whatever, but polypharmacy in general, because, let's face it, I don't know a percentage, but I'm sure the great number of percentage of our patients who have dyslipidemia also have something else. It's not usually going to be the only thing they have, right. So they're probably going to have diabetes or they're going to, you know, they're going to have something else that's in play that is going to also be causing a lot of medications to be prescribed and to have to be taken. So what are some of the tips and tricks that you can share on on that whole aspect of managing the polypharmacy and making sure that our dyslipidemia medication is not getting lost in the shuffle because of something else.

Speaker 2:

Yeah Right, I think a really important thing is to empower the patients and get them to have a current list of their medications that they carry with them all the time, including supplements, including vitamins. It was amazing in our clinic how many times patients would come in and just have no idea what they were on and maybe they had been on a statin previously and we weren't sure if they were still on it. And then you add one, you know, and so encouraging them to take charge of that and always have a current list. I think another thing is ensuring that we are using medications when we can that work with the patient's lifestyle.

Speaker 2:

So let's say, a patient says you know, I cannot remember to take simvastatin at night. It's not going to happen. I don't remember to take any medications at night. Okay, we can work with that. Maybe we'll switch it to atorvastatin or rosuvastatin. How long or how fast you can take it in the morning, and maybe that will help with adherence. You had mentioned the medication synchronization. That's huge that pharmacists can do. We would recommend pill boxes. I know you know people wouldn't always be on board with that, but as soon as they realize that it takes the guesswork, the thinking, out of it. You could work with them that way as well.

Speaker 1:

Yeah, I mean, I'm in my early 40s and I take no shame in having a pillbox.

Speaker 2:

I love my pillbox, I know I mean.

Speaker 1:

I just I filled it up this morning and I love organization, I love, you know, to keep it on track and I think that that just that's always something that we can recommend our patients. It makes the most sense to me. So yeah, sure, so we briefly touched on this as well. But obviously, statin hesitancy, statin misconceptions you know there's a lot of unfortunately negative press that gets associated with statins and and for some reasons, rightfully so. But but in general they're, they're great drugs and you know patients should be on them, most patients should be on them, most patients should be on them if they're prescribed them. So any kind of things that you've learned over the years that kind of helps with that. I know, just education in general and I love, again, setting it up with where are you getting your information from? I love that. That's going to stick with me. But, yeah, anything else in that space that can kind of help overcome that hesitancy or the reluctance, for that, sure.

Speaker 2:

What we'd hear a lot of times is you know, my sister was on a statin and had problems so I can't take it, or you know I'm not going to because my neighbor had problems and things like that, and so you know, interestingly, you see a lot of that. But there are different statins that patients can try. Some of the you know again atorvastatin or suvastatin are pretty clean, have longer half-lives, you know, and so patients may do well with them, and if they don't, we always have options. You know, we could try a different statin, we can try a lower dose, we could try alternative dosing. Lots of data on once a week, twice a week, three times a week, statins especially with those that have the longer half-lives for certain.

Speaker 2:

Like you had mentioned, making sure that you, if a patient is getting their information from Google or Reddit or you know wherever they get it from, having some sources that you can point them to. You know, there's a great site here on the American Heart Association, or here I just printed out a handout from you know, american heart association or something like that. So having some options so that we're not telling them where you're going, isn't good, but, um, giving them some options to go get that, that information redirecting as opposed to right getting on to them.

Speaker 1:

Yeah, exactly exactly.

Speaker 2:

And then I think some persistence to. You know you're probably not going to get convince them the first time, but what we would even do is say you know, just get take it a couple times this week, see how you feel, and then you know we can maybe titrate up as as we go, but that kind of helps them dip their toe in the water and get a little bit of confidence to give it, to give it a go.

Speaker 1:

Great feedback, great ideas and ways to kind of frame that conversation with the patient. So that's good. Well, I told you time's going to run out before we realize it. So we're already running out of time. But before we go, I want to be sure is there anything else in this space, chanel, that you're like, oh, I was just dying to tell everybody about this? Is there anything else that you want us to be sure we know about this lipidemia or the therapies associated with it, before we head out? And if not, then my final, final question to you is what's the game changer here? You know, what is the absolute take home point here? How can we really utilize the information that you've given us to make a difference? So sure.

Speaker 2:

Well, we'll jump to the game changer, since we're running out of time here. But I think for me, from my perspective, the game changer is that the pharmacists are the game changers in this, in this space, and the patients, when those prescriptions come in and they're not picking them up, you know, asking a few questions, being kind of persistent, finding out why and being the source of that good information, that reliable information we mentioned earlier, staying up to date on that and helping the patients be educated and helping them navigate this. I think sometimes they're scared, they're nervous, they're getting all kinds of information, so helping them navigate that and lead through all of it is important. So, yeah, I think the pharmacists are the game changers. I love that.

Speaker 1:

And I think it's great. I think it's important that we also don't dismiss their concerns, and everything you've shared is setting it up in that same way, like, don't dismiss it. They have valid concerns and, again, some of the evidence is it is true, you know they are rough on, you know the body sometimes, but, like you said, there are so many ways in which we can approach that therapy and I think that is where you can shine as the pharmacist and being like look, yes, I know, I agree they can. You know it can be difficult, you might have a side effect, but I know all about how to make this better for you and you still get the outcome that you need. So, yeah, so I agree, pharmacists are the game changer. I agree 100%. Well, janelle, this was lovely. Thank you so much for your time today and for reminding us about all things dyslipidemia and for giving us some great updates and great take-home nuggets. Really appreciate your time.

Speaker 2:

Well, thank you. Thank you for having me. I really enjoyed it and it was a privilege to be here today. Thank you.

Speaker 1:

If you're a CE Plan subscriber, be sure to claim your CE credit for this episode of Game Changers by logging in at ceimpactcom. And, as always, have a great week and keep learning. I can't wait to dig into another game-changing topic with you all again next week.