Bakris

Basile

Brown

Fisher

Gaede

Hemmelgarn

J. A. Johnson

Johnson

Majumdar

McLean

Peikes

Planas

R. Spooner

R. T. Tsuyuki

R. Z. Lewanczuk

Rothman

S. H. Simpson

S. R. Majumdar

Simpson

Staessen

Stevens

The CDC Diabetes Cost-effectiveness Group

Tsuyuki

English

PubMed


                  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.
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Scot H. Simpson

Sumit R. Majumdar

Ross T. Tsuyuki

Richard Z. Lewanczuk

Richard Spooner

Jeffrey A. Johnson

Crossref

Diabetes Care

Effect of Adding Pharmacists to Primary Care Teams on Blood Pressure Control in Patients With Type 2 Diabetes

A Canadian consensus for the standardized evaluation of quality improvementinterventionsintype2diabetes. Can J Diabetes 2005;2005:220– 19. Stevens

Or is it? Lancet 1997;350(Suppl. 1):SI4– SI9 2. Morrish

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3005466

Effect of Adding Pharmacists to Primary Care Teams on Blood Pressure Control in Patients With Type 2 Diabetes: A randomized controlled trial

Effect of Adding Pharmacists to Primary Care Teams on Blood Pressure Control in Patients With Type 2 Diabetes: A randomized controlled trial

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