Titre
Impact of pharmacist care in the management of cardiovascular disease risk factors: a systematic review and meta-analysis of randomized trials.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Santschi, Valérie
Auteure/Auteur
Chiolero, Arnaud
Auteure/Auteur
Burnand, Bernard
Auteure/Auteur
Colosimo April, L.
Auteure/Auteur
Paradis, Gilles
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1538-3679
Statut éditorial
Publié
Date de publication
2011
Volume
171
Numéro
16
Première page
1441
Dernière page/numéro d’article
1453
Peer-reviewed
Oui
Langue
anglais
Résumé
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.
PID Serval
serval:BIB_5DDCC82B60E8
PMID
Open Access
Oui
Date de création
2011-09-20T12:48:28.434Z
Date de création dans IRIS
2025-05-20T20:02:16Z
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BIB_5DDCC82B60E8.P001.pdf
Version du manuscrit
preprint
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502.86 KB
Format
Adobe PDF
PID Serval
serval:BIB_5DDCC82B60E8.P001
Somme de contrôle
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