Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2020 Jan;86(1):29-38.
doi: 10.1111/bcp.14164. Epub 2020 Jan 3.

Impact of the pharmacist-led intervention on the control of medical cardiovascular risk factors for the primary prevention of cardiovascular disease in general practice: A systematic review and meta-analysis of randomised controlled trials

Abdullah A Alshehri  1   2 , Zahraa Jalal  1 , Ejaz Cheema  1 , M Sayeed Haque  3 , Duncan Jenkins  4 , Asma Yahyouche  1
Affiliations
Meta-Analysis

Impact of the pharmacist-led intervention on the control of medical cardiovascular risk factors for the primary prevention of cardiovascular disease in general practice: A systematic review and meta-analysis of randomised controlled trials

Abdullah A Alshehri et al. Br J Clin Pharmacol. 2020 Jan.

Abstract

Aims: To conduct a systematic review and meta-analysis of the effectiveness of general practice-based pharmacist interventions in reducing the medical risk factors for the primary prevention of cardiovascular events.

Methods: A systemic search was undertaken in 8 databases: PubMed, MEDLINE, EMBAS, PsycINFO, Cochrane Library, CINAHL Plus, SCOPUS and Science Citation Index, with no start date up to 27 March 2019. Randomised controlled trials assessing the effectiveness of pharmacist-led interventions delivered in the general practice in reducing the medical risk factors of cardiovascular events were included in the review. The risk of bias in the studies was assessed using the Cochrane risk of bias tool.

Results: A total of 1604 studies were identified, with 21 randomised controlled trials (8933 patients) meeting the inclusion criteria. Fourteen studies were conducted in patients with diabetes, 7 in hypertension, 2 involving dyslipidaemia, and 2 with hypertension and diabetes together. The most frequently used interventions were medication review and medication management. The quality of the included studies was variable. Patients receiving pharmacist-led interventions were associated with a statistically significant reduction in their systolic blood pressure (-9.33 mmHg [95% Confidence Interval (CI) -13.36 to -5.30]), haemoglobin A1C (-0.76% [95% CI -1.15 to -0.37]) and low-density lipoprotein-cholesterol (-15.19 mg/dL [95% CI -24.05 to -6.33]). Moreover, practice-based pharmacists' interventions were also reported to have a positive impact on patient adherence to medications.

Conclusion: The findings of this review suggest that pharmacist-led interventions in general practice can significantly reduce the medical risk factors of cardiovascular disease events. These findings support the involvement of pharmacists as healthcare providers in managing patients with hypertension, diabetes and dyslipidaemia.

Keywords: cardiovascular disease; general practice; pharmacist.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of study selection process. RCT, randomised controlled trial; GP, general practice; PCP, primary care physician
Figure 2
Figure 2
Risk of bias graph: the review authors' judgments about each risk‐of‐bias item presented as percentages across all included studies
Figure 3
Figure 3
Forest plots show the effect of pharmacist intervention on the mean difference in systolic blood pressure (A) and in diastolic blood pressure (B)
Figure 4
Figure 4
Forest plots show the effect of pharmacist intervention on the mean difference in haemoglobin A1C
Figure 5
Figure 5
Forest plots show the effect of pharmacist intervention on the mean difference in Total cholesterol (A), low‐density lipoprotein–cholesterol (B), high‐density lipoprotein–cholesterol (C) and in triglyceride (D), in pharmacist and usual care groups show an
See this image and copyright information in PMC

References

    1. WHO . Cardiovascular diseases (CVDs), 2017. Available from: http://www.who.int/mediacentre/factsheets/fs317/en/. Accessed 20 March 2018.
    1. Piepoli MF, Hoes AW, Agewall S, et al. 2016 European guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2016;37(29):2315‐2381. - PMC - PubMed
    1. Wilkins E, Wilson L, Wickramasinghe K, et al. European Cardiovascular Disease Statistics 2017. European Heart Network: Brussels; 2017.
    1. Kannel WB, McGee DL. Diabetes and cardiovascular disease: the Framingham study. Jama. 1979;241(19):2035‐2038. - PubMed
    1. Yusuf S, Hawken S, Ounpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case‐control study. Lancet (London, England). 2004;364(9438):937‐952. - PubMed

LinkOut - more resources