Pharmacist intervention confers benefits on cardiovascular outcomes
Pharmacist interventions help improve cardiovascular disease management, including risk factor control, better medication adherence, and reduction in morbidity and mortality, a study has found.
The researchers explored the databases of Medline, Embase, and the Cochrane Library from inception to July 2021 and identified meta-analyses of randomized controlled trials. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to evaluate the quality of evidence.
A total of 9,308 publications were identified, of which 149 full-text articles were assessed for inclusion. Only 24 studies with 85 unique meta-analyses examining the effects of pharmacist intervention on cardiovascular risk factors and outcomes were included in the umbrella review.
Of the 85 unique meta-analyses, 61 (71.7 percent) reported significant impacts of pharmacist intervention. Based on the GRADE approach, 63.4 percent of meta-analyses had large heterogeneity (I2 >50 percent), whereas 1.2 percent were graded as high quality, 16.5 percent moderate, 32.9 percent low, and 49.4 percent very low.
In meta-analyses with moderate quality, pharmacist intervention led to a significant reduction in risk factors (including 6/3-mm Hg decrease in blood pressure, an increase in the rate of lipid control [pooled odds ratio (OR), 1.91, 95 percent confidence interval (CI), 1.55‒2.35], glucose control [OR, 3.11, 95 percent CI, 2.3‒4.3], and smoking cessation [OR, 2.3, 95 percent CI, 1.33‒3.97]), as well as improved adherence to medication (OR, 1.67, 95 percent CI, 1.38‒2.02).
Pharmacist interventions also resulted in a significant decrease in all-cause mortality (OR, 0.72, 95 percent CI, 0.58‒0.89) and better quality of life among patients suffering from chronic heart failure.