Abdullah A Alshehri1,2, Zahraa Jalal1, Ejaz Cheema1, M Sayeed Haque3, Duncan Jenkins4, Asma Yahyouche1. 1. School of Pharmacy, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK. 2. Clinical Pharmacy Department, College of Pharmacy, Taif University, Al Huwaya, Taif, Saudi Arabia. 3. Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK. 4. Morph Consultancy Ltd, Worcester, UK.
Abstract
AIMS: To conduct a systematic review and meta-analysis of the effectiveness of general practice-based pharmacist interventions in reducing the medical risk factors for the primary prevention of cardiovascular events. METHODS: A systemic search was undertaken in 8 databases: PubMed, MEDLINE, EMBAS, PsycINFO, Cochrane Library, CINAHL Plus, SCOPUS and Science Citation Index, with no start date up to 27 March 2019. Randomised controlled trials assessing the effectiveness of pharmacist-led interventions delivered in the general practice in reducing the medical risk factors of cardiovascular events were included in the review. The risk of bias in the studies was assessed using the Cochrane risk of bias tool. RESULTS: A total of 1604 studies were identified, with 21 randomised controlled trials (8933 patients) meeting the inclusion criteria. Fourteen studies were conducted in patients with diabetes, 7 in hypertension, 2 involving dyslipidaemia, and 2 with hypertension and diabetes together. The most frequently used interventions were medication review and medication management. The quality of the included studies was variable. Patients receiving pharmacist-led interventions were associated with a statistically significant reduction in their systolic blood pressure (-9.33 mmHg [95% Confidence Interval (CI) -13.36 to -5.30]), haemoglobin A1C (-0.76% [95% CI -1.15 to -0.37]) and low-density lipoprotein-cholesterol (-15.19 mg/dL [95% CI -24.05 to -6.33]). Moreover, practice-based pharmacists' interventions were also reported to have a positive impact on patient adherence to medications. CONCLUSION: The findings of this review suggest that pharmacist-led interventions in general practice can significantly reduce the medical risk factors of cardiovascular disease events. These findings support the involvement of pharmacists as healthcare providers in managing patients with hypertension, diabetes and dyslipidaemia.
AIMS: To conduct a systematic review and meta-analysis of the effectiveness of general practice-based pharmacist interventions in reducing the medical risk factors for the primary prevention of cardiovascular events. METHODS: A systemic search was undertaken in 8 databases: PubMed, MEDLINE, EMBAS, PsycINFO, Cochrane Library, CINAHL Plus, SCOPUS and Science Citation Index, with no start date up to 27 March 2019. Randomised controlled trials assessing the effectiveness of pharmacist-led interventions delivered in the general practice in reducing the medical risk factors of cardiovascular events were included in the review. The risk of bias in the studies was assessed using the Cochrane risk of bias tool. RESULTS: A total of 1604 studies were identified, with 21 randomised controlled trials (8933 patients) meeting the inclusion criteria. Fourteen studies were conducted in patients with diabetes, 7 in hypertension, 2 involving dyslipidaemia, and 2 with hypertension and diabetes together. The most frequently used interventions were medication review and medication management. The quality of the included studies was variable. Patients receiving pharmacist-led interventions were associated with a statistically significant reduction in their systolic blood pressure (-9.33 mmHg [95% Confidence Interval (CI) -13.36 to -5.30]), haemoglobin A1C (-0.76% [95% CI -1.15 to -0.37]) and low-density lipoprotein-cholesterol (-15.19 mg/dL [95% CI -24.05 to -6.33]). Moreover, practice-based pharmacists' interventions were also reported to have a positive impact on patient adherence to medications. CONCLUSION: The findings of this review suggest that pharmacist-led interventions in general practice can significantly reduce the medical risk factors of cardiovascular disease events. These findings support the involvement of pharmacists as healthcare providers in managing patients with hypertension, diabetes and dyslipidaemia.
Authors: Shamala Ayadurai; V Bruce Sunderland; Lisa B G Tee; Siti N Md Said; H Laetitia Hattingh Journal: J Diabetes Date: 2018-07-18 Impact factor: 4.006
Authors: Karen L Margolis; Stephen E Asche; Anna R Bergdall; Steven P Dehmer; Sarah E Groen; Holly M Kadrmas; Tessa J Kerby; Krissa J Klotzle; Michael V Maciosek; Ryan D Michels; Patrick J O'Connor; Rachel A Pritchard; Jaime L Sekenski; JoAnn M Sperl-Hillen; Nicole K Trower Journal: JAMA Date: 2013-07-03 Impact factor: 56.272
Authors: Phayom Sookaneknun; Robert M E Richards; Jaratbhan Sanguansermsri; Chai Teerasut Journal: Ann Pharmacother Date: 2004-11-02 Impact factor: 3.154
Authors: N N Ladhani; S R Majumdar; J A Johnson; R T Tsuyuki; R Z Lewanczuk; R Spooner; S H Simpson Journal: Diabet Med Date: 2012-11 Impact factor: 4.359
Authors: Michele Heisler; Timothy P Hofer; Julie A Schmittdiel; Joe V Selby; Mandi L Klamerus; Hayden B Bosworth; Martin Bermann; Eve A Kerr Journal: Circulation Date: 2012-05-08 Impact factor: 29.690
Authors: Thomas G H Kempen; Maria Bertilsson; Nermin Hadziosmanovic; Karl-Johan Lindner; Håkan Melhus; Elisabet I Nielsen; Johanna Sulku; Ulrika Gillespie Journal: JAMA Netw Open Date: 2021-04-01
Authors: Joan O'Connell; Laura Grau; Spero M Manson; Anne Marie Bott; Kyle Sheffer; Randy Steers; Luohua Jiang Journal: J Am Coll Clin Pharm Date: 2022-05-25