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 randomized controlled trials

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Abstract

Aims:
To conduct a systematic review and meta-analysis of the effectiveness of general practice based pharmacists’ interventions in reducing the medical risk factors for the primary prevention of cardiovascular events.

Methods:
A systemic search was undertaken in eight databases: PubMed, MEDLINE, EMBAS, PsycINFO, Cochrane Library, CINAHL Plus, SCOPUS and Science Citation Index, with no start date up to 27th March 2019. Randomised controlled trials assessing the effectiveness of pharmacists-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 1,604 studies were identified, with 21 RCTs (8,933 patients) meeting the inclusion criteria. 14 studies were conducted in patients with diabetes, seven in hypertension, two involving dyslipidaemia and two 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 pharmacists-led interventions were associated with a statistically significant reduction in their systolic blood pressure -9.33 mmHg [95% CI -13.36 to -5.30]), HbA1c -0.76% [95% CI -1.15 to -0.37]) and LDL-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.

Conclusions:
The findings of this review suggest that Pharmacists-led interventions in general practice can significantly reduce the medical risk factors of CVD events. These findings support the involvement of pharmacists as healthcare providers in managing patients with hypertension, diabetes and dyslipidaemia.

Details

Original languageEnglish
Pages (from-to)1-10
Number of pages10
JournalBritish Journal of Clinical Pharmacology
Early online date27 Nov 2019
Publication statusE-pub ahead of print - 27 Nov 2019

Keywords

  • pharmacist, general practice, cardiovascular disease