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

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State: Public
Version: author
Serval ID
serval:BIB_5DDCC82B60E8
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Impact of pharmacist care in the management of cardiovascular disease risk factors: a systematic review and meta-analysis of randomized trials.
Journal
Archives of Internal Medicine
Author(s)
Santschi Valérie, Chiolero Arnaud, Burnand Bernard, Colosimo April L., Paradis Gilles
ISSN
1538-3679 (Electronic)
ISSN-L
0003-9926
Publication state
Published
Issued date
2011
Peer-reviewed
Oui
Volume
171
Number
16
Pages
1441-1453
Language
english
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.
Keywords
Blood Pressure, Cardiovascular Diseases/epidemiology, Cardiovascular Diseases/prevention & control, Cholesterol/blood, Cholesterol, LDL/blood, Female, Humans, Male, Patient Education as Topic/statistics & numerical data, Pharmacists, Professional-Patient Relations, Randomized Controlled Trials as Topic, Risk Factors, Smoking/epidemiology, Treatment Outcome
Pubmed
Web of science
Open Access
Yes
Create date
20/09/2011 14:48
Last modification date
20/08/2019 15:15
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