Adding pharmacists to primary care teams improved the achievement of a ≥10% decrease in systolic blood pressure at 1 year versus usual care (37% vs 23%; OR 1.9; 95% CI 1.1-3.3; P=0.02).
RCT (n=260)
Blinded ascertainment of outcomes
Yes
Does adding pharmacists to primary care teams improve blood pressure control in patients with type 2 diabetes?
Adding pharmacists to primary care teams significantly improves blood pressure control and reduces predicted 10-year cardiovascular risk in patients with type 2 diabetes.
Odds Ratio: 1.9 (95% CI 1.1–3.3)
Absolute Event Rate: 37% vs 23%
p-value: p=0.02
OBJECTIVE: To evaluate the effect of adding pharmacists to primary care teams on the management of hypertension and other cardiovascular risk factors in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: We conducted a randomized controlled trial with blinded ascertainment of outcomes within primary care clinics in Edmonton, Canada. Pharmacists performed medication assessments and limited history and physical examinations and provided guideline-concordant recommendations to optimize medication management. Follow-up contact was completed as necessary. Control patients received usual care. The primary outcome was a ≥10% decrease in systolic blood pressure at 1 year. RESULTS: A total of 260 patients were enrolled, 57% were women, the mean age was 59 years, diabetes duration was 6 years, and blood pressure was 129/74 mmHg. Forty-eight of 131 (37%) intervention patients and 30 of 129 (23%) control patients achieved the primary outcome (odds ratio 1.9 95% CI 1.1-3.3; P = 0.02). Among 153 patients with inadequately controlled hypertension at baseline, intervention patients (n = 82) were significantly more likely than control patients (n = 71) to achieve the primary outcome (41 50% vs. 20 28%; 2.6 1.3-5.0; P = 0.007) and recommended blood pressure targets (44 54% vs. 21 30%; 2.8 1.4-5.4; P = 0.003). The 10-year risk of cardiovascular disease, based on changes to the UK Prospective Diabetes Study Risk Engine, were predicted to decrease by 3% for intervention patients and 1% for control patients (P = 0.005). CONCLUSIONS: Significantly more patients with type 2 diabetes achieved better blood pressure control when pharmacists were added to primary care teams, which suggests that pharmacists can make important contributions to the primary care of these patients.
Simpson et al. (Thu,) conducted a rct in Type 2 diabetes (n=260). Adding pharmacists to primary care teams vs. Usual care was evaluated on ≥10% decrease in systolic blood pressure at 1 year (OR 1.9, 95% CI 1.1-3.3, p=0.02). Adding pharmacists to primary care teams improved the achievement of a ≥10% decrease in systolic blood pressure at 1 year versus usual care (37% vs 23%; OR 1.9; 95% CI 1.1-3.3; P=0.02).