BC Clinical impact of medication reviews with follow-up in cardiovascular older patients in primary care: A cluster-randomized controlled trial.
- Publisher:
- WILEY
- Publication Type:
- Journal Article
- Citation:
- Br J Clin Pharmacol, 2023, 89, (7), pp. 2131-2143
- Issue Date:
- 2023-07
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Full metadata record
Field | Value | Language |
---|---|---|
dc.contributor.author | Martínez-Mardones, F | |
dc.contributor.author | Benrimoj, SI | |
dc.contributor.author | Ahumada-Canale, A | |
dc.contributor.author | Plaza-Plaza, JC | |
dc.contributor.author | Garcia-Cardenas, V | |
dc.date.accessioned | 2023-10-05T03:46:12Z | |
dc.date.available | 2023-01-29 | |
dc.date.available | 2023-10-05T03:46:12Z | |
dc.date.issued | 2023-07 | |
dc.identifier.citation | Br J Clin Pharmacol, 2023, 89, (7), pp. 2131-2143 | |
dc.identifier.issn | 0306-5251 | |
dc.identifier.issn | 1365-2125 | |
dc.identifier.uri | http://hdl.handle.net/10453/172513 | |
dc.description.abstract | AIMS: Cardiovascular diseases (CVD) are the primary cause of death in Chile. Pharmacist-led medication review with follow-up (MRF) has improved CVD risk factors control in Europe and North America. However, their healthcare systems differ from Chile's, precluding generalizability. This trial aimed to determine the effect of MRF on CVD risk factor control among older patients with polypharmacy attending public primary care centres in Chile. METHODS: A cluster-randomized controlled trial was conducted in 24 centres. Patients older than 65 years with moderate-to-high CVD risk, five or more medications, hypertension, type 2 diabetes or dyslipidaemia, received MRF in addition to usual care or usual care alone for 12 months. Primary outcome measures were clinical goal achievement for hypertension, type 2 diabetes and dyslipidaemia, as well as medication adherence, medication number and CVD risk score. Adjusted generalized estimating equations were used, with odds ratios (ORs) for binary measures and mean differences for continuous measures. RESULTS: In total, 324 patients from 12 centres (174 MRF group, 150 usual care group, six centres each) received four pharmacist visits. Significant improvements were found for goal achievement in hypertension (OR 4.37, 95% confidence interval [CI] 2.54 to 7.51, P = .001), LDL cholesterol (OR 3.67, 95% CI 2.13 to 6.33, P = .001), type 2 diabetes (OR 6.97, 95% CI 3.69 to 13.2, P = .001), medication adherence (OR 6.60, 95% CI 1.36 to 31.9, P = .022), medications number (-0.86, 95% CI -1.14 to -0.58, P < .001) and CVD risk score (-2.27, 95% CI -2.84 to -1.69, P < .001). CONCLUSION: Pharmacist-led medication review with follow-up improved cardiovascular disease risk factor control and medication adherence. This study supports pharmacists' inclusion in primary care teams. | |
dc.format | Print-Electronic | |
dc.language | eng | |
dc.publisher | WILEY | |
dc.relation.ispartof | Br J Clin Pharmacol | |
dc.relation.isbasedon | 10.1111/bcp.15682 | |
dc.rights | info:eu-repo/semantics/openAccess | |
dc.subject | 1115 Pharmacology and Pharmaceutical Sciences | |
dc.subject.classification | Pharmacology & Pharmacy | |
dc.subject.classification | 3214 Pharmacology and pharmaceutical sciences | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Diabetes Mellitus, Type 2 | |
dc.subject.mesh | Follow-Up Studies | |
dc.subject.mesh | Medication Review | |
dc.subject.mesh | Hypertension | |
dc.subject.mesh | Cardiovascular Diseases | |
dc.subject.mesh | Dyslipidemias | |
dc.subject.mesh | Primary Health Care | |
dc.subject.mesh | Medication Adherence | |
dc.subject.mesh | Pharmacists | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Cardiovascular Diseases | |
dc.subject.mesh | Hypertension | |
dc.subject.mesh | Diabetes Mellitus, Type 2 | |
dc.subject.mesh | Follow-Up Studies | |
dc.subject.mesh | Pharmacists | |
dc.subject.mesh | Primary Health Care | |
dc.subject.mesh | Dyslipidemias | |
dc.subject.mesh | Medication Adherence | |
dc.subject.mesh | Medication Review | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Diabetes Mellitus, Type 2 | |
dc.subject.mesh | Follow-Up Studies | |
dc.subject.mesh | Medication Review | |
dc.subject.mesh | Hypertension | |
dc.subject.mesh | Cardiovascular Diseases | |
dc.subject.mesh | Dyslipidemias | |
dc.subject.mesh | Primary Health Care | |
dc.subject.mesh | Medication Adherence | |
dc.subject.mesh | Pharmacists | |
dc.title | BC Clinical impact of medication reviews with follow-up in cardiovascular older patients in primary care: A cluster-randomized controlled trial. | |
dc.type | Journal Article | |
utslib.citation.volume | 89 | |
utslib.location.activity | England | |
utslib.for | 1115 Pharmacology and Pharmaceutical Sciences | |
pubs.organisational-group | /University of Technology Sydney | |
pubs.organisational-group | /University of Technology Sydney/Faculty of Health | |
pubs.organisational-group | /University of Technology Sydney/Faculty of Health/Centre for Health Economics Research and Evaluation | |
utslib.copyright.status | open_access | * |
dc.date.updated | 2023-10-05T03:46:10Z | |
pubs.issue | 7 | |
pubs.publication-status | Published | |
pubs.volume | 89 | |
utslib.citation.issue | 7 |
Abstract:
AIMS: Cardiovascular diseases (CVD) are the primary cause of death in Chile. Pharmacist-led medication review with follow-up (MRF) has improved CVD risk factors control in Europe and North America. However, their healthcare systems differ from Chile's, precluding generalizability. This trial aimed to determine the effect of MRF on CVD risk factor control among older patients with polypharmacy attending public primary care centres in Chile. METHODS: A cluster-randomized controlled trial was conducted in 24 centres. Patients older than 65 years with moderate-to-high CVD risk, five or more medications, hypertension, type 2 diabetes or dyslipidaemia, received MRF in addition to usual care or usual care alone for 12 months. Primary outcome measures were clinical goal achievement for hypertension, type 2 diabetes and dyslipidaemia, as well as medication adherence, medication number and CVD risk score. Adjusted generalized estimating equations were used, with odds ratios (ORs) for binary measures and mean differences for continuous measures. RESULTS: In total, 324 patients from 12 centres (174 MRF group, 150 usual care group, six centres each) received four pharmacist visits. Significant improvements were found for goal achievement in hypertension (OR 4.37, 95% confidence interval [CI] 2.54 to 7.51, P = .001), LDL cholesterol (OR 3.67, 95% CI 2.13 to 6.33, P = .001), type 2 diabetes (OR 6.97, 95% CI 3.69 to 13.2, P = .001), medication adherence (OR 6.60, 95% CI 1.36 to 31.9, P = .022), medications number (-0.86, 95% CI -1.14 to -0.58, P < .001) and CVD risk score (-2.27, 95% CI -2.84 to -1.69, P < .001). CONCLUSION: Pharmacist-led medication review with follow-up improved cardiovascular disease risk factor control and medication adherence. This study supports pharmacists' inclusion in primary care teams.
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