Impact of the pharmacist‐led intervention on the control of medical cardiovascular risk factors for the primary prevention of cardiovascular disease in general practice: A systematic review and meta‐analysis of randomised controlled trials

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. K E Y W O R D Scardiovascular disease, general practice, pharmacist PI statement: The authors confirm that the Principal Investigator for this paper is Abdullah A. Alshehri and that he had direct clinical responsibility for patients.

Patient acceptability of targeted risk-based detection of non-communicable diseases in a dental and pharmacy setting

“…In addition to pharmacist role in optimising the use of medicines in liaison with GPs, providing advice about safe and effective use of medicines when dispensing to patients with prescriptions for the treatment of diabetes, heart disease and hypertension and thus relieving the pressure on the GP practices and A&E. Furthermore, pharmacists work directly in general practice as part of the multi-disciplinary team, in patient facing roles when managing conditions such as diabetes and hypertension [ 13 ]. A recent systematic review and meta-analysis which included 21 RCTs (8933 patients) showed that pharmacists-led interventions, as part of a team in general practice, can significantly reduce medical risk factors of CVD events when managing patients with hypertension, diabetes and dyslipidaemia [ 14 ].…”

Cost of contact: redesigning healthcare in the age of COVID

“…Community pharmacists have been shown to support medication reconciliation and adherence, which can improve chronic disease management. [20][21][22][23][24] Retinal screening in people with diabetes can be done using remote technology at an optometrist's office, with data being analysed off-site by trained ophthalmologists. 25 Technology, including wearable devices like portable oxygen saturation monitors and home blood pressure monitors that connect to electronic medical records, may also partially fill in portions of the clinical exam.…”

Pharmacist-Led Intervention on the Inappropriate use of Stress Ulcer Prophylaxis Pharmacotherapy in Intensive Care Units: A Systematic Review

“…[1] Many studies have con rmed that pharmacists' direct intervention or participation in multidisciplinary management teams can improve the clinical outcome and quality of life of patients by optimizing the use of drugs in different disease processes. [2][3][4][5][6][7][8][9] As a member of a multidisciplinary management team, pharmacists make full use of their professional knowledge and clinical experience to perform an important role in the care of intensive care unit (ICU) patients. [10] A previous systematic review su ciently dissected the impact on patient outcomes of pharmacist participation in multidisciplinary critical care teams.…”