Meta-analsysis of pharmacist interventions for cardiovascular disease risk factors

January 01, 0001

Meta-analsysis of pharmacist interventions for cardiovascular disease risk factors

Pharmacists may improve the clinical management of major risk factors for cardiovascular disease (CVD) prevention. A systematic review was conducted by Canadian authors to determine the impact of pharmacist care on the management of CVD risk factors among outpatients. 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.

They found: "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); total cholesterol (9 studies, 1121 patients; -17.4 mg/L) low-density lipoprotein cholesterol (7 studies, 924 patients; -13.4 mg/L), and a reduction in the risk of smoking (2 studies, 196 patients; relative risk, 0.77). While most studies tended to favor pharmacist care compared with usual care, a substantial heterogeneity was observed."

The authors concluded: "Pharmacist-directed care or in collaboration with physicians or nurses improve the management of major CVD risk factors in outpatients."

It would be helpful to know what it is about pharmacist- directed care that leads to the observed changes.

For the full abstract, click here.

Arch Intern Med 171(16):1441-1453, 12 September 2011 © 2011 to the American Medical Association
Impact of Pharmacist Care in the Management of Cardiovascular Disease Risk Factors-A Systematic Review and Meta-analysis of Randomized Trials. Valérie Santschi, Arnaud Chiolero, Bernard Burnand, April L. Colosimo, Gilles Paradis. Correspondence to Dr. Santschi: [email protected]

Category: HSR. Health Services Research, K. Circulatory. Keywords: cardiovascular disease, prevention, pharmacist care, educational interventions, patient-reminder systems, medication management, meta-analysis of randomized controlled trials, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 27 September 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.