Pharmacist-led and community health worker-led interventions resulted in the greatest systolic blood pressure reductions of -7.3 mm Hg (95% CI, -9.1 to -5.6) and -7.1 mm Hg (95% CI, -10.8 to -3.4).
Meta-Analysis (n=90,474)
Yes
Does the type of health care professional delivering interventions improve blood pressure reduction in patients with hypertension?
Pharmacist- and community health worker-led interventions are the most effective strategies for reducing blood pressure in patients with hypertension.
Effect estimate: Mean reduction -7.3 mm Hg (pharmacist-led) (95% CI -9.1 to -5.6)
BACKGROUND: Globally, only 13.8% of patients with hypertension have their blood pressure (BP) controlled. Trials testing interventions to overcome barriers to BP control have produced mixed results. Type of health care professional delivering the intervention may play an important role in intervention success. The goal of this meta-analysis is to determine which health care professionals are most effective at delivering BP reduction interventions. METHODS: We searched Medline and Embase (until December 2023) for randomized controlled trials of interventions targeting barriers to hypertension control reporting who led intervention delivery. One hundred articles worldwide with 116 comparisons and 90 474 participants with hypertension were included. Trials were grouped by health care professional, and the effects of the intervention on systolic and diastolic BP were combined using random effects models and generalized estimating equations. RESULTS: Pharmacist-led interventions , community health worker-led interventions, and health educator-led interventions resulted in the greatest systolic BP reductions of -7.3 (95% CI, -9.1 to -5.6), -7.1 (95% CI, -10.8 to -3.4), and -5.2 (95% CI, -7.8 to -2.6) mm Hg, respectively. Interventions led by multiple health care professionals, nurses, and physicians also resulted in significant systolic BP reductions of -4.2 (95% CI, -6.1 to -2.4), -3.0 (95% CI, -4.2 to -1.9), and -2.4 (95% CI, -3.4 to -1.5) mm Hg, respectively. Similarly, the greatest diastolic BP reductions were -3.9 (95% CI, -5.2 to -2.5) mm Hg for pharmacist-led and -3.7 (95% CI, -6.6 to -0.8) mm Hg for community health worker-led interventions. In pairwise comparisons, pharmacist were significantly more effective than multiple health care professionals, nurses, and physicians at delivering interventions. CONCLUSIONS: Pharmacists and community health workers are most effective at leading BP intervention implementation and should be prioritized in future hypertension control efforts.
Mills et al. (Fri,) conducted a meta-analysis in Hypertension (n=90,474). Health care professional-led interventions (pharmacists, community health workers, etc.) vs. Other health care professionals (pairwise comparisons) was evaluated on Systolic blood pressure reduction (Mean reduction -7.3 mm Hg (pharmacist-led), 95% CI -9.1 to -5.6). Pharmacist-led and community health worker-led interventions resulted in the greatest systolic blood pressure reductions of -7.3 mm Hg (95% CI, -9.1 to -5.6) and -7.1 mm Hg (95% CI, -10.8 to -3.4).
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