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Background Cardiovascular disease is a national priority, with a strategy shifting towards preventative care. CR programmes are optimally placed to offer secondary prevention, however, approaches can vary between providers across the integrated care system (ICS).Aims To standardise lipid profile reviews for patient’s post-acute coronary syndrome (ACS) within CR; increase patient engagement with those declining exercise and publication of a lipid optimisation pathway.Methods A pharmacist role was imbedded across three CR providers, and weekly clinics established at each site to review patient’s lipid profiles. 1461 patients were referred to CR following an ACS event during the 12-month period. Patients triaged and identified as not meeting LDL-C targets (<1.9 mmol/L), were contacted to arrange a review. Following review, patients were discharged to primary care. Complex patients were discussed in an MDT. Patients who declined exercise were contacted with an offer of a medication review, to re-engage them with the service.Results Of the 1461 patients referred to CR, 387 did not engage with the exercise programme. Of the 387, 150 (35%) patients accepted a pharmacist review. A total of 500 patients received a pharmacist appointment; 267 (55%) patients had an adjustment in LLT. To date, 198 (71%) patients have had a repeat lipid profile in community, of which 138 (70%) are to target ( table 1). An ICS guideline has been published locally. Qualitative feedback from patients and clinicians was positive, with many valuing the service for addressing medication queries promptly. Abstract P14 Table 1Table displaying patient cohort reviewed in pharmacist clinics and outcomes % Total Patients in Pharmacy Service 500 100% A Total Appointments 534 B Total number of lipid lowering therapy (LLT) changes 276 55% C Total patients had retest post LLT modification 198 71% D Total patients to target post primary care retest* 138 70% E Total patients not on exercise, seen by pharmacist 137 35%+ F Total patients DNA pharmacist appointment 23 4.6% G Total number of CR referrals over 12-month period 1461 H Uptake of patients to exercise programme 1074 *Target LDL-C <1.9 mmol/L. +35% calculated based on 137 out of 387 patients who did not uptake an exercise programme.Conclusion Inclusion of a pharmacist role within CR helps provide individualised medicines optimisation, linking directly to risk factor management. Improvements include timely addressing of sub-optimal lipid profiles, optimisation of pharmacotherapy, and greater population health benefits. The introduction of this service has led to improved lipid profiles and has potential to expand as a service to provide holistic secondary prevention clinics.