Format

Send to:

Choose Destination
See comment in PubMed Commons below
Ann Pharmacother. 2007 Nov;41(11):1770-81. Epub 2007 Oct 9.

Sensitivity of patient outcomes to pharmacist interventions. Part II: Systematic review and meta-analysis in hypertension management.

Author information

  • 1Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.

Abstract

BACKGROUND:

Hypertension is a major health concern worldwide due to its deleterious impact. Few studies have quantitatively assessed pharmacists' interventions in hypertensive patients.

OBJECTIVES:

To identify and quantify outcomes sensitive to pharmacists' interventions.

METHODS:

International Pharmaceutical Abstracts, MEDLINE, Cochrane Central, and EMBASE were searched from inception through December 2006. Two independent reviewers identified articles; results were compared and resolved through consensus. Data extracted included intervention type, patient numbers, demographics, study characteristics, instruments used, data compared, and outcomes reported. A random effects meta-analysis was used to combine data. Study quality was assessed using the Downs-Black scale.

RESULTS:

Of 203 potential articles identified, 98 were selected and their abstracts were read. Nine of these were reviewed full-text and 19 more were identified from references, resulting in a total of 28 articles. Research designs included 18 randomized controlled trials, 6 single-arm clinical trials, 3 nonrandomized comparative trials, and 1 database study. Average quality score was 66% +/- 12% (fair). Medication management (82%) and hypertension education (68%) were the interventions most used. Thirty-nine study results (57% of all outcomes evaluated) were sensitive to pharmacists' interventions. Meta-analysis of 2246 patients in 13 studies found that pharmacists' interventions significantly reduced systolic blood pressure (10.7 +/- 11.6 mm Hg; p = 0.002), while controls remained unchanged (3.2 +/- 12.1 mm Hg; p = 0.361). Pharmacists' interventions further reduced systolic blood pressure (6.9 +/- 12.1 mm Hg; p = 0.047) over controls. Nonsensitive results included further reduction in diastolic blood pressure (3.6 +/- 3.7 mm Hg; p = 0.06), quality of life (1 of 8 significant), and adherence (5 of 13 significant).

CONCLUSIONS:

Systolic blood pressure is sensitive to pharmacists' interventions. Other outcomes may also be sensitive; however, more high-quality studies are needed for a comprehensive quantitative assessment.

PMID:
17925496
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Loading ...
    Write to the Help Desk