Impact of pharmacist care in the management of cardiovascular disease risk factors: a systematic review and meta-analysis of randomized trials.

TitreImpact of pharmacist care in the management of cardiovascular disease risk factors: a systematic review and meta-analysis of randomized trials.
Publication TypeJournal Article
Year of Publication2011
AuthorsSantschi, V, Chiolero, A, Burnand, B, Colosimo, AL, Paradis, G
JournalArch Intern Med
Volume171
Issue16
Pagination1441-53
Date Published2011 Sep 12
DOI10.1001/archinternmed.2011.399
ISSN1538-3679
Mots-clésBlood Pressure, Cardiovascular Diseases, Cholesterol, Cholesterol, LDL, Female, Humans, Male, Patient Education as Topic, Pharmacists, Professional-Patient Relations, Randomized Controlled Trials as Topic, Risk Factors, Smoking, Treatment Outcome
Abstract

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.

Alternate URL

http://www.ncbi.nlm.nih.gov/pubmed/21911628?dopt=Abstract

Alternate JournalArch. Intern. Med.
Citation Key / SERVAL ID3111
PubMed ID21911628
Grant List / / Canadian Institutes of Health Research / Canada
                         

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