The results of this pilot study suggest that ProFiL can be implemented and may help community pharmacists intervene more frequently to manage drug-related problems. However, a larger-scale study with longer follow-up is necessary to evaluate the impact of the program on management of drug-related problems and its clinical relevance.
Objective In patients with chronic kidney disease (CKD), blood‐pressure (BP) control is crucial. ProFiL, a training and communication‐network programme, is designed to optimize community pharmacists' management of drug‐related problems among CKD outpatients. This study evaluates the impact of ProFiL on BP control and management of hypertension treatment.
Methods In a 6‐month cluster randomized trial, community pharmacies of CKD outpatients (creatinine clearance, <60 ml/min) attending a predialysis clinic in Quebec, Canada, were randomly assigned to ProFiL (intervention) or usual care (UC). ProFiL community pharmacists attended a training workshop, received patient information and had access to a hospital‐pharmacist consultation service. UC pharmacists provided routine care.
Key findings Eighty‐nine patients (ProFiL, 48; UC, 41) participated. At 6 months, adjusted mean systolic/diastolic BP changes, taking within‐cluster correlation into account, were −6.9/−0.4 mmHg in ProFiL patients compared with +4.7/+2.2 mmHg in UC (between‐groups differences, P value = 0.021/0.348). Some 41 hypertension drug‐related problems were identified. Community pharmacists wrote 25 recommendations (ProFiL, 24; UC, 1; P value = 0.007), 12 of which, all by ProFiL pharmacists, dealt with hypertension (P value = 0.009 compared with UC). Patients with written hypertension recommendations had a greater decrease in mean systolic BP (−11.6 mmHg; P value = 0.035), and BP was controlled in a higher proportion of them (relative risk, 2.14; P value = 0.011).
Conclusion ProFiL, a collaborative and multidisciplinary care programme, may help pharmacists to intervene more often to detect and manage hypertension drug‐related problems and optimize BP control in CKD outpatients.
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