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The impact of interventions by pharmacists in community pharmacies on control of hypertension: a systematic review and meta‐analysis of randomized controlled trials
Author(s) -
Cheema Ejaz,
Sutcliffe Paul,
Singer Donald R. J.
Publication year - 2014
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.12452
Subject(s) - medicine , randomized controlled trial , psychological intervention , cochrane library , blood pressure , meta analysis , cinahl , medline , confidence interval , pharmacist , psycinfo , relative risk , pharmacy , physical therapy , intensive care medicine , family medicine , nursing , political science , law
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 N ovember 2013, with no start date ( W eb of S cience, E mbase, The C ochrane L ibrary, M edline O vid, B iomed C entral, Biosis Citation Index, CINAHL , P syc INFO ). 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 C ochrane 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 mm H g (95% confidence interval, −3.8 to −8.4 mm H g); P < 0.00001] and diastolic blood pressure [11 studies (2246 patients); −2.5 mm H g (95% confidence interval, −1.5 to −3.4 mm H g); 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.