The Role of Pharmacists in Shared Decision-Making for Dyslipidemia Management

Walking through the pharmacy aisles at the Walgreens on Michigan Avenue near Millennium Park, I overheard a conversation that’s becoming all too familiar in Chicago these days. A patient was asking their pharmacist about the out-of-pocket cost for a newer lipid-lowering therapy, worried it might force them to choose between their heart health and their monthly rent in Lincoln Park. This isn’t just an isolated moment—it reflects a broader shift happening in exam rooms and neighborhood pharmacies across the city, where shared decision-making is moving from a clinical ideal to a practical necessity, especially when managing atherosclerotic cardiovascular disease in the aftermath of the pandemic-era disruptions that still linger in our healthcare systems.

The guidance for pharmacists navigating high-cost lipid therapies, which emphasizes their central role in guiding patients through options, cost considerations, and ongoing monitoring, resonates deeply here in Chicago. With its vast network of safety-net hospitals like Cook County Health and academic medical centers such as Rush University Medical Center and Northwestern Memorial Hospital, the city sits at a unique intersection where cutting-edge lipid-lowering innovations meet stark realities of access and affordability. Pharmacists in community settings—from the independent shops in Pilsen to the chain locations in Englewood—are increasingly tasked with translating complex clinical guidelines into conversations that produce sense for someone juggling multiple jobs, managing Medicaid paperwork, or trying to afford both their statin and their child’s asthma inhaler.

What makes this moment particularly salient in Chicago is how it intersects with long-standing efforts to rebuild trust in healthcare, especially within Black and Latino communities that have historically faced disparities in cardiovascular outcomes. The Adv Ther. 2025 study on shared decision-making for restoring trust in atherosclerotic cardiovascular disease management highlights how collaborative approaches can prevent disease progression—not just through better medication adherence, but by addressing the lived experiences that influence health decisions. In a city where life expectancy can vary by as much as 30 years between neighborhoods like Streeterville and Washington Park, these conversations aren’t just clinical; they’re acts of equity.

Pharmacists here are uniquely positioned to bridge that gap. They’re often the most accessible healthcare providers—open late, walk-in friendly, and embedded in the fabric of daily life. When a patient at a CVS in Humboldt Park hesitates to fill a prescription for a PCSK9 inhibitor due to cost, the pharmacist doesn’t just check insurance; they explore manufacturer assistance programs, discuss therapeutic alternatives with the prescribing clinic at Sinai Chicago, and help the patient weigh short-term financial strain against long-term risks of untreated high LDL. This isn’t theoretical—it’s happening in real time, shaped by Chicago’s specific mix of urban challenges and robust public health infrastructure.

Given my background in public health journalism, if this trend impacts you in Chicago, here are the three types of local professionals you need to realize about when navigating lipid-lowering therapy decisions:

• Clinical Pharmacists in Safety-Net Settings: Glance for professionals affiliated with institutions like Cook County Health or Mile Square Health Center who specialize in medication therapy management for chronic conditions. They should have demonstrable experience working with diverse populations, understand Illinois Medicaid formularies, and be able to connect patients to local resources like the Chicago Department of Public Health’s medication access programs.
• Community Health Workers with Cardiovascular Focus: Seek out individuals embedded in neighborhood organizations—such as those working through the Greater Auburn-Gresham Development Corporation or the Latino Organization of the Southwest—who’ve received training in motivational interviewing and lipid management. Their value lies in their ability to navigate cultural nuances, accompany patients to appointments, and help sustain lifestyle changes that complement medication.
• Ambulatory Care Pharmacists in Academic Medical Centers: These specialists, often found in clinics associated with Rush, Northwestern, or the University of Chicago Medicine, excel at managing complex dyslipidemia cases. Prioritize those who participate in shared decision-making training, offer telehealth follow-ups for transportation-challenged patients, and actively collaborate with primary care providers across the city’s Federally Qualified Health Centers.

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