Pharmacist-Led Interventions Contribute to Heart Disease Prevention

November 29, 2019

Pharmacist-led initiatives, such as medication therapy management, for chronic diseases can significantly improve patient outcomes.

Pharmacist-led interventions can have a significant effect on lowering patients’ risk of cardiovascular disease (CVD), according to a new study published in the British Journal of Clinical Pharmacology.1

Strategies including patient education, medication review, and physical assessments can all enhance patients’ wellbeing and contribute to the prevention of CVD for those who are at risk.

The study, which was led by Abdullah Alshehri of the University of Birmingham, analyzed 21 relevant randomized controlled clinical trials comprising a total of 8933 patients. Interventions involved patient education, medication review and counseling, physical assessment, assessing adherence, lifestyle modification, and medication management (such as prescribing, adjusting, monitoring, and administering therapy, and identifying drug-related problems). Patients in the studies included those with diabetes, hypertension, dyslipidemia, and hypertension and diabetes together.1

According to the review, the most frequently used pharmacist-led interventions were medication review and medication management.1

Overall, the analysis showed that patients receiving pharmacist-led interventions experienced a statistically significant reduction in systolic blood pressure by an average of -9.33 mmHg, Hemoglobin A1c by an average of -0.76%, and low-density lipoprotein-cholesterol by an average of -15.19 mg/dl. Additionally, pharmacist-led interventions appeared to improve patient adherence to prescribed medication regimens, the researchers noted.1

Offering management services for chronic conditions, such as diabetes, not only enhances patient outcomes but serves as a business opportunity for community pharmacies as well. In addition to improving pharmacist-patient communication, medication therapy management is one way for pharmacists to receive reimbursement for their services.

Pharmacists’ interventions have previously been linked with increased cardiovascular benefits in other studies. A study published in JAMA Network Open evaluated the impact of pharmacy closures on patients receiving cardiovascular medications, including statins, beta-blockers, and oral anticoagulants.2

Using information from a national all-payer pharmacy dispensing database, the researchers of the JAMA study analyzed data collected from more than 3 million adults aged 50 years and older who filled at least 1 statin prescription at a retail pharmacy between 2011 and 2016.2

Pharmacy closures appeared to directly affect medication adherence rates, particularly for older patients living in neighborhoods with fewer pharmacies. Overall, patients filling prescriptions at pharmacies that closed experienced an immediate statistically and clinically significant decline in adherence during the first 3 months after closure, the study found.2

These findings, combined with the most recent study, indicate the importance of the involvement of pharmacists as health care providers in helping to manage patients with chronic conditions.  

“The evidence presented in this review providers an important message to health systems and policy makers regarding the effectiveness of general practice-based pharmacists’ interventions,” Alshehri said in a statement about the study.3 “The significant reductions in blood pressure, blood glucose, and blood cholesterol reported in this meta-analysis, if sustained in clinical practice, could have significant implications for managing hypertension, diabetes, and dyslipidemia that could prevent cardiovascular morbidity and mortality.”

References:

1. Alshehri AA, Jalal Z, Cheema E, et al. Impact of the pharmacist-led intervention on the control of medical cardiovascular risk factors for the primary prevention of cardiovascular disease in general practice: a systematic review and meta-analysis of randomized controlled trials. British Journal of Clinical Pharmacology. 2019. https://doi.org/10.1111/bcp.14164

2. Qato DM. Alexander GC, Chakraborty A, et al. Association between pharmacy closures and adherence to cardiovascular medications among older US adults. JAMA Network Open. 2019. Doi: doi:10.1001/jamanetworkopen.2019.2606.
3. Pharmacist-Led Interventions May Help Prevent Cardiovascular Disease [news release]. Wiley's website. https://newsroom.wiley.com/press-release/british-journal-clinical-pharmacology/pharmacist-led-interventions-may-help-prevent-ca. Accessed November 29, 2019.