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Randomized Controlled Trial
. 2011 Jan;34(1):20-6.
doi: 10.2337/dc10-1294. Epub 2010 Oct 7.

Effect of adding pharmacists to primary care teams on blood pressure control in patients with type 2 diabetes: a randomized controlled trial

Scot H Simpson  1 , Sumit R Majumdar, Ross T Tsuyuki, Richard Z Lewanczuk, Richard Spooner, Jeffrey A Johnson
Affiliations
Randomized Controlled Trial

Effect of adding pharmacists to primary care teams on blood pressure control in patients with type 2 diabetes: a randomized controlled trial

Scot H Simpson et al. Diabetes Care. 2011 Jan.

Abstract

Objective: To evaluate the effect of adding pharmacists to primary care teams on the management of hypertension and other cardiovascular risk factors in patients with type 2 diabetes.

Research design and methods: We conducted a randomized controlled trial with blinded ascertainment of outcomes within primary care clinics in Edmonton, Canada. Pharmacists performed medication assessments and limited history and physical examinations and provided guideline-concordant recommendations to optimize medication management. Follow-up contact was completed as necessary. Control patients received usual care. The primary outcome was a ≥10% decrease in systolic blood pressure at 1 year.

Results: A total of 260 patients were enrolled, 57% were women, the mean age was 59 years, diabetes duration was 6 years, and blood pressure was 129/74 mmHg. Forty-eight of 131 (37%) intervention patients and 30 of 129 (23%) control patients achieved the primary outcome (odds ratio 1.9 [95% CI 1.1-3.3]; P = 0.02). Among 153 patients with inadequately controlled hypertension at baseline, intervention patients (n = 82) were significantly more likely than control patients (n = 71) to achieve the primary outcome (41 [50%] vs. 20 [28%]; 2.6 [1.3-5.0]; P = 0.007) and recommended blood pressure targets (44 [54%] vs. 21 [30%]; 2.8 [1.4-5.4]; P = 0.003). The 10-year risk of cardiovascular disease, based on changes to the UK Prospective Diabetes Study Risk Engine, were predicted to decrease by 3% for intervention patients and 1% for control patients (P = 0.005).

Conclusions: Significantly more patients with type 2 diabetes achieved better blood pressure control when pharmacists were added to primary care teams, which suggests that pharmacists can make important contributions to the primary care of these patients.

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Figures

Figure 1
Figure 1
Study participant flowchart. ICD-9, International Classification of Diseases, 9th revision; BP, blood pressure; ITT, intention to treat.
Figure 2
Figure 2
Proportion of patients achieving a ≥10% decrease in systolic blood pressure at 1 year (primary outcome).
See this image and copyright information in PMC

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