Table 28Heart failure: strength of evidence for pharmacist-led multicomponent intervention

InterventionNumber of Studies; Subjects (Analyzed)OutcomeRisk of BiasConsistencyDirectnessPrecisionMagnitude of Effect and Strength of Evidence
Heart failure pharmacist-led intervention vs. usual care1; 314
(314 for MEMS caps,
NR for MPR or self-report)
Medication AdherenceRCT
Medium
UnknownDirectPreciseStat sig difference in percentage points for taking medication (MEMS) at 9 months: 10.9
Stat sig difference in percentage points for adherence to timing (MEMS) at 9 months: 5.9
Stat sig difference in percentage points for MPR over 12 months: 4.2
No significant difference for self-report
Low
1; 314 (NR)Quality of lifeRCT
Medium
UnknownDirectImpreciseNo stat sig difference

Insufficient
1; 314 (NR)Patient satisfactionRCT
Medium
UnknownDirectPreciseStat sig difference between groups of 0.3 on 12-point validated questionnaire
Low
1; 314 (314)Health care utilization:
All-cause ED visits, hosp, and Combined ED visits and hosp
RCT
Medium
UnknownDirectPrecise for all-cause ED visits and all-cause ED+hosp; Imprecise for all-cause hospStat sig difference of 0.52 mean all-cause ED visits and 0.69 mean all-cause ED+hosp between groups
Low
All-cause hosp: no stat sig difference
Insufficient
1; 314 (314)Health care utilization:
CV-related and HF-related events
RCT
Medium
UnknownDirectImpreciseNo stat sig difference

Insufficient
1; 314 (314)CostsRCT
Medium
UnknownDirectImpreciseNo stat sig difference

Insufficient

Abbreviations: CV = cardiovascular; ED = emergency department; HF = heart failure; hosp = hospitalization; MEMS = medication event monitoring system; MPR = medication possession ratio; NR = not reported; RCT = randomized controlled trial; stat sig = statistically significant.

From: Results

Cover of Closing the Quality Gap: Revisiting the State of the Science (Vol. 4: Medication Adherence Interventions: Comparative Effectiveness)
Closing the Quality Gap: Revisiting the State of the Science (Vol. 4: Medication Adherence Interventions: Comparative Effectiveness).
Evidence Reports/Technology Assessments, No. 208.4.
Viswanathan M, Golin CE, Jones CD, et al.

PubMed Health. A service of the National Library of Medicine, National Institutes of Health.