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Pharmacist interventions to enhance blood pressure control and adherence to antihypertensive therapy: Review and meta-analysis

dc.contributor.authorMorgado, Manuel
dc.contributor.authorMorgado, Sandra
dc.contributor.authorMendes, Liliana
dc.contributor.authorPereira, L.
dc.contributor.authorCastelo-Branco, Miguel
dc.date.accessioned2011-01-26T21:37:08Z
dc.date.available2011-01-26T21:37:08Z
dc.date.issued2011-02-01
dc.descriptionA literature review and meta–analysis showed that pharmacist interventions can significantly improve medication adherence, SBP, DBP, and BP control in patients with essential hypertension. Interventions were complex and multifaceted and included medication management in all analyzed studies.por
dc.description.abstractPurpose. Pharmacist interventions to enhance blood pressure (BP) control and adherence to antihypertensive therapy in adults with essential hypertension were reviewed. Methods. A literature search was conducted to identify relevant articles describing pharmacist interventions intended to improve adherence to antihypertensive medications. Studies were included if they described a pharmacist intervention to improve medication adherence and analyzed adherence to therapy and BP control as outcomes. A fixed-effects model was used to combine data from randomized controlled trials. Results. A total of 15 studies were identified, testing 16 different interventions and containing data on 3280 enrolled patients. Although 87.5% of the interventions resulted in significant improvements in treatment outcomes, only 43.8% of the interventions were associated with significant increases in medication adherence. All interventions that increased antihypertensive medication adherence also significantly reduced BP. Almost all the interventions that were effective in increasing adherence to medication were complex, including combinations of different strategies. Meta-analysis of 2619 patients in 8 studies found that pharmacist interventions significantly reduced systolic blood pressure (SBP) (p < 0.001) and diastolic blood pressure (DBP) (p = 0.002) and that the meta-analytic differences in SBP and DBP changes from baseline to endpoint in intervention and control groups were –4.9 ± 0.9 mm Hg (p < 0.001) and –2.6 ± 0.9 mm Hg (p < 0.001), respectively. Conclusion. A literature review and meta-analysis showed that pharmacist interventions can significantly improve medication adherence, SBP, DBP, and BP control in patients with essential hypertension. Interventions were complex and multifaceted and included medication management in all analyzed studies.por
dc.description.sponsorshipSupported by fellowship grant SFRH/BD/36756/2007 from the Fundação para a Ciência e a Tecnologia.por
dc.identifier.issn1079-2082
dc.identifier.urihttp://hdl.handle.net/10400.6/658
dc.language.isoengpor
dc.peerreviewedyespor
dc.publisherAmerican Society of Health-System Pharmacistspor
dc.relation.ispartofseriesDOI 10.2146/ajhp090656;
dc.relation.publisherversionhttp://www.ajhp.org/cgi/content/abstract/68/3/241por
dc.subjectBlood pressurepor
dc.subjectCompliancepor
dc.subjectHypertensionpor
dc.subjectHypotensive agentspor
dc.subjectInterventionspor
dc.subjectPatientspor
dc.subjectPharmacistspor
dc.titlePharmacist interventions to enhance blood pressure control and adherence to antihypertensive therapy: Review and meta-analysispor
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage253por
oaire.citation.issueVol 68 Feb 1, 2011por
oaire.citation.startPage241por
oaire.citation.titleAmerican Journal of Health-System Pharmacypor
person.familyNameNunes Vicente Passos Morgado
person.familyNamePereira
person.familyNameCASTELO-BRANCO CRAVEIRO SOUSA
person.givenNameManuel Augusto
person.givenNameLuísa
person.givenNameMIGUEL
person.identifierAAG-4910-2021
person.identifierF-7869-2010
person.identifier.ciencia-id7617-9FDC-2D9D
person.identifier.ciencia-id4F15-1868-D001
person.identifier.ciencia-idE91D-05E2-A2C1
person.identifier.orcid0000-0003-2112-2835
person.identifier.orcid0000-0002-9068-4607
person.identifier.orcid0000-0002-6191-5912
person.identifier.scopus-author-id55955252600
person.identifier.scopus-author-id10839238300
person.identifier.scopus-author-id36730721300
rcaap.rightsopenAccesspor
rcaap.typearticlepor
relation.isAuthorOfPublication7c614887-225f-44d4-b467-3cc34e44a98b
relation.isAuthorOfPublication604e508e-9f4e-4950-b2a4-1b06c7192afe
relation.isAuthorOfPublication67c51098-b7e8-4164-bcfe-528b50e11bfd
relation.isAuthorOfPublication.latestForDiscovery604e508e-9f4e-4950-b2a4-1b06c7192afe

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