2011/09/12 by Valérie Santschi · 296 citations
Medicine · Nursing · #Pharmaceutical Practices and Patient Outcomes #Medication Adherence and Compliance #Medicine #Pharmacist #Psychological intervention #Relative risk #Randomized controlled trial #CINAHL #Clinical pharmacy #Blood pressure #Confidence interval #MEDLINE #Internal medicine #Emergency medicine #Family medicine #Pharmacy #Nursing
paper · doi:10.1001/archinternmed.2011.399
published in Archives of Internal Medicine 171(16), 1441 (American Medical Association)
openalex publication_date 2011/09/12 · openalex created_date 2016/06/24 · openalex updated_date 2026/08/05
BACKGROUND: Pharmacists may improve the clinical management of major risk factors for cardiovascular disease (CVD) prevention. A systematic review was conducted to determine the impact of pharmacist care on the management of CVD risk factors among outpatients. METHODS: The MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials databases were searched for randomized controlled trials that involved pharmacist care interventions among outpatients with CVD risk factors. Two reviewers independently abstracted data and classified pharmacists' interventions. Mean changes in blood pressure, total cholesterol, low-density lipoprotein cholesterol, and proportion of smokers were estimated using random effects models. RESULTS: Thirty randomized controlled trials (11,765 patients) were identified. Pharmacist interventions exclusively conducted by a pharmacist or implemented in collaboration with physicians or nurses included patient educational interventions, patient-reminder systems, measurement of CVD risk factors, medication management and feedback to physician, or educational intervention to health care professionals. Pharmacist care was associated with significant reductions in systolic/diastolic blood pressure (19 studies [10,479 patients]; -8.1 mm Hg [95% confidence interval CI, -10.2 to -5.9]/-3.8 mm Hg [95% CI,-5.3 to -2.3]); total cholesterol (9 studies [1121 patients]; -17.4 mg/L [95% CI,-25.5 to -9.2]), low-density lipoprotein cholesterol (7 studies [924 patients]; -13.4 mg/L [95% CI,-23.0 to -3.8]), and a reduction in the risk of smoking (2 studies [196 patients]; relative risk, 0.77 [95% CI, 0.67 to 0.89]). While most studies tended to favor pharmacist care compared with usual care, a substantial heterogeneity was observed. CONCLUSION: Pharmacist-directed care or in collaboration with physicians or nurses improve the management of major CVD risk factors in outpatients.