Physician–Pharmacist Cooperation Program for Blood Pressure Control in Patients With Hypertension: A Randomized-Controlled Trial

Tobari, Hiroko; Arimoto, Takanori; Shimojo, Nobutake; Yuhara, Kiyomi; Noda, Hiroyuki; Yamagishi, Kazumasa; Iso, Hiroyasu

doi:10.1038/ajh.2010.127

Cited by 51 publications

(60 citation statements)

References 22 publications

(28 reference statements)

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“…Seven studies 35,46,59,60,66,67,70 were judged to be of limited quality and excluded from all analyses. There-fore, 52 studies 21–34,36–45,47–58,61–65,68,69,71–76,95–97 were included in the Community Guide review (Figure 2). …”

Section: Evidence Synthesismentioning

confidence: 99%

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Team-Based Care and Improved Blood Pressure Control

Proia

Thota

Njie

et al. 2014

American Journal of Preventive Medicine

205

166

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Context Uncontrolled hypertension remains a widely prevalent cardiovascular risk factor in the U.S. team-based care, established by adding new staff or changing the roles of existing staff such as nurses and pharmacists to work with a primary care provider and the patient. Team-based care has the potential to improve the quality of hypertension management. The goal of this Community Guide systematic review was to examine the effectiveness of team-based care in improving blood pressure (BP) outcomes. Evidence acquisition An existing systematic review (search period, January 1980–July 2003) assessing team-based care for BP control was supplemented with a Community Guide update (January 2003–May 2012). For the Community Guide update, two reviewers independently abstracted data and assessed quality of eligible studies. Evidence synthesis Twenty-eight studies in the prior review (1980–2003) and an additional 52 studies from the Community Guide update (2003–2012) qualified for inclusion. Results from both bodies of evidence suggest that team-based care is effective in improving BP outcomes. From the update, the proportion of patients with controlled BP improved (median increase=12 percentage points); systolic BP decreased (median reduction=5.4 mmHg); and diastolic BP also decreased (median reduction=1.8 mmHg). Conclusions Team-based care increased the proportion of people with controlled BP and reduced both systolic and diastolic BP, especially when pharmacists and nurses were part of the team. Findings are applicable to a range of U.S. settings and population groups. Implementation of this multidisciplinary approach will require health system–level organizational changes and could be an important element of the medical home.

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Section: Evidence Synthesismentioning

confidence: 99%

“…71 Forty-one studies 21,22,24–27,30,31,33,34,36– 45,47,49–52,54–58,61,63,64,68,69,71–75,95,96 were implemented solely within healthcare settings and nine studies 23,28,29,32,48,53,65,76,97 were implemented in community settings. One study was conducted both in a healthcare system and a community setting.…”

Section: Evidence Synthesismentioning

confidence: 99%

Team-Based Care and Improved Blood Pressure Control

Proia

Thota

Njie

et al. 2014

American Journal of Preventive Medicine

205

166

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“…These consisted of the following (some papers described more than one study type):12 systematic reviews (5 of RCTs of pharmacist-led behavioural interventions for smoking [15–19], 1 of process elements of such interventions [20], 3 of pharmacist-led behavioural interventions other than smoking cessation [15, 19, 21], 1 of the scope of pharmacy practice [4], 1 of pharmacists’ perceptions [13], and 1 of qualitative studies of the patient experience [22]);6 reviews not described as ‘systematic’, of pharmacy business models, pharmacist scope of practice, pharmacist training programmes or the process elements of RCTs [2, 23–27];18 RCTs, of which 14 related to smoking cessation [28–41] and 4 to other behavioural interventions [42–45];1 cost-effectiveness study linked to a RCT [40];1 paper describing additional process detail on a RCT [46];12 evaluations of pharmacist training courses, using either pre-post classroom assessments or ‘mystery shopper’ assessments of performance in practice, comprising 2 linked to RCTs [28, 29] and 10 before and after studies [47–56];7 papers reporting quantitative surveys (6 of pharmacists [57–62] and 4 of service users [57, 58, 63, 64]);6 papers describing qualitative studies, 5 based on semi-structured interviews (3 of pharmacists [3, 65, 66], 1 of pharmacy owners [67], 2 of service users [3, 65], 1 of researchers [68]) and 1 a focus group study of service users [69];2 in-depth case studies [70, 71];2 business models [67, 72];1 paper describing the development of a complex intervention [73]. …”

Section: Resultsmentioning

confidence: 99%

“…18 RCTs, of which 14 related to smoking cessation [28–41] and 4 to other behavioural interventions [42–45];…”

Section: Resultsmentioning

confidence: 99%

What works for whom in pharmacist-led smoking cessation support: realist review

Greenhalgh

Macfarlane

Steed

2016

BMC Med

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BackgroundNew models of primary care are needed to address funding and staffing pressures. We addressed the research question “what works for whom in what circumstances in relation to the role of community pharmacies in providing lifestyle interventions to support smoking cessation?”MethodsThis is a realist review conducted according to RAMESES standards. We began with a sample of 103 papers included in a quantitative review of community pharmacy intervention trials identified through systematic searching of seven databases. We supplemented this with additional papers: studies that had been excluded from the quantitative review but which provided rigorous and relevant additional data for realist theorising; citation chaining (pursuing reference lists and Google Scholar forward tracking of key papers); the ‘search similar citations’ function on PubMed. After mapping what research questions had been addressed by these studies and how, we undertook a realist analysis to identify and refine candidate theories about context-mechanism-outcome configurations.ResultsOur final sample consisted of 66 papers describing 74 studies (12 systematic reviews, 6 narrative reviews, 18 RCTs, 1 process detail of a RCT, 1 cost-effectiveness study, 12 evaluations of training, 10 surveys, 8 qualitative studies, 2 case studies, 2 business models, 1 development of complex intervention). Most studies had been undertaken in the field of pharmacy practice (pharmacists studying what pharmacists do) and demonstrated the success of pharmacist training in improving confidence, knowledge and (in many but not all studies) patient outcomes. Whilst a few empirical studies had applied psychological theories to account for behaviour change in pharmacists or people attempting to quit, we found no studies that had either developed or tested specific theoretical models to explore how pharmacists’ behaviour may be affected by organisational context. Because of the nature of the empirical data, only a provisional realist analysis was possible, consisting of five mechanisms (pharmacist identity, pharmacist capability, pharmacist motivation and clinician confidence and public trust). We offer hypotheses about how these mechanisms might play out differently in different contexts to account for the success, failure or partial success of pharmacy-based smoking cessation efforts.ConclusionSmoking cessation support from community pharmacists and their staff has been extensively studied, but few policy-relevant conclusions are possible. We recommend that further research should avoid duplicating existing literature on individual behaviour change; seek to study the organisational and system context and how this may shape, enable and constrain pharmacists’ extended role; and develop and test theory.

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“…Therefore, further studies are needed to compare 'real-life' HBPM vs. 'guidelinesdriven' HBPM diagnostic and prognostic values. In the meantime, further effort should be put forth worldwide on GP education and probably on greater collaboration with both pharmacists and nurses which appear necessary to improve proper patient implementation of HBPM in more and less complex interventions [41][42][43][44][45][46].…”

Section: Devices Featuresmentioning

confidence: 98%