Impact of pharmacist care in the management of XXXX risk factors: a systematic review and meta-analysis of randomized trials.

@entity1 @entity551 @entity65 @entity165
BACKGROUND: Pharmacists may improve the clinical management of major risk factors for @entity65 ( @entity65 ) prevention. A systematic review was conducted to determine the impact of pharmacist care on the management of @entity65 risk factors among outpatients. METHODS: The MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials databases were searched for randomized controlled trials that involved pharmacist care interventions among outpatients with @entity65 risk factors. Two reviewers independently abstracted data and classified pharmacists' interventions. Mean changes in blood pressure, total @entity165 , low-density lipoprotein @entity165 , and proportion of smokers were estimated using random effects models. RESULTS: Thirty randomized controlled trials (11,765 @entity1 ) were identified. Pharmacist interventions exclusively conducted by a pharmacist or implemented in collaboration with physicians or nurses included @entity1 educational interventions, @entity1 -reminder systems, measurement of @entity65 risk factors, medication management and feedback to physician, or educational intervention to health care professionals. Pharmacist care was associated with significant @entity551 (19 studies [10,479 @entity1 ]; -8.1 mm Hg [95% confidence interval {CI}, -10.2 to -5.9]/-3.8 mm Hg [95% CI,-5.3 to -2.3]); total @entity165 (9 studies [1121 @entity1 ]; -17.4 mg/L [95% CI,-25.5 to -9.2]), low-density lipoprotein @entity165 (7 studies [924 @entity1 ]; -13.4 mg/L [95% CI,-23.0 to -3.8]), and a reduction in the risk of smoking (2 studies [196 @entity1 ]; relative risk, 0.77 [95% CI, 0.67 to 0.89]). While most studies tended to favor pharmacist care compared with usual care, a substantial heterogeneity was observed. CONCLUSION: Pharmacist-directed care or in collaboration with physicians or nurses improve the management of major @entity65 risk factors in outpatients.
