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Meta-Analysis
. 2014 Dec;78(6):1238-47.
doi: 10.1111/bcp.12452.

The impact of interventions by pharmacists in community pharmacies on control of hypertension: a systematic review and meta-analysis of randomized controlled trials

Ejaz Cheema  1 , Paul Sutcliffe, Donald R J Singer
Affiliations
Meta-Analysis

The impact of interventions by pharmacists in community pharmacies on control of hypertension: a systematic review and meta-analysis of randomized controlled trials

Ejaz Cheema et al. Br J Clin Pharmacol. 2014 Dec.

Abstract

Aims: To undertake a systematic review and meta-analysis of randomized controlled trials concerned with the impact of community pharmacist-led interventions on blood pressure control in patients with hypertension.

Methods: Eight electronic databases were searched up to 30 November 2013, with no start date (Web of Science, Embase, The Cochrane Library, Medline Ovid, Biomed Central, Biosis Citation Index, CINAHL, PsycINFO). All studies included were randomized controlled trials involving patients with hypertension, with or without cardiovascular-related co-morbidities, with difference in blood pressure as an outcome. Data collected included the study design, baseline characteristics of study populations, types of interventions and outcomes. The Cochrane tool was used to assess risk of bias.

Results: From 340 articles identified on initial searching, 16 randomized controlled trials (3032 patients) were included. Pharmacist-led interventions were patient education on hypertension, management of prescribing and safety problems associated with medication, and advice on lifestyle. These interventions were associated with significant reductions in systolic [11 studies (2240 patients); -6.1 mmHg (95% confidence interval, -3.8 to -8.4 mmHg); P < 0.00001] and diastolic blood pressure [11 studies (2246 patients); -2.5 mmHg (95% confidence interval, -1.5 to -3.4 mmHg); P < 0.00001].

Conclusions: Community pharmacist-led interventions can significantly reduce systolic and diastolic blood pressure. These interventions could be useful for improving clinical management of hypertension.

Keywords: hypertension; meta-analysis; pharmacists; randomized controlled trial.

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Figures

Figure 1
Figure 1
Prisma flow diagram
Figure 2
Figure 2
Cochrane risk-of-bias graph . Authors' judgements about each risk-of-bias item are presented as percentages across all included studies. formula image, low risk of bias; formula image, unclear risk of bias; formula image, high risk of bias
Figure 3
Figure 3
Forest plot comparisons of experimental (intervention) vs. control groups in 11 studies for systolic blood pressure (A) and diastolic blood pressure (B). #Indicates studies including patients with cardiovascular-related co-morbidities. Mckenney , Park , Garcao , Sookaneknun , Zillich , Fornos , Krass , Doucette , Ali , Amariles , Svarstad
See this image and copyright information in PMC

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