Pharmacist interventions to improve hypertension management: protocol for a systematic review of randomised controlled trials

Introduction Hypertension management remains a major public health challenge in primary care. Innovative interventions to improve blood pressure (BP) control are needed. One approach is through community-based models of care with the involvement of pharmacists and other non-physician healthcare prof...

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Main Authors: Ross Tsuyuki, Arnaud Chiolero, Gilles Paradis, Cinzia Del Giovane, Valérie Santschi, Viktoria Gastens, Blanche Kiszio
Format: Article
Language:English
Published: BMJ Publishing Group 2022-05-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/12/5/e059399.full
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author Ross Tsuyuki
Arnaud Chiolero
Gilles Paradis
Cinzia Del Giovane
Valérie Santschi
Viktoria Gastens
Blanche Kiszio
author_facet Ross Tsuyuki
Arnaud Chiolero
Gilles Paradis
Cinzia Del Giovane
Valérie Santschi
Viktoria Gastens
Blanche Kiszio
author_sort Ross Tsuyuki
collection DOAJ
description Introduction Hypertension management remains a major public health challenge in primary care. Innovative interventions to improve blood pressure (BP) control are needed. One approach is through community-based models of care with the involvement of pharmacists and other non-physician healthcare professionals. Our objective is to systematically review the evidence of the impact of pharmacist care alone or in collaboration with other healthcare professionals on BP among hypertensive outpatients compared with usual care. Because these interventions can be complex, with various components, the effect size may differ between the type of interventions. One major focus of our study will be to assess carefully the heterogeneity in the effects of these interventions to identify which ones work best in a given healthcare setting.Methods and analysis Systematic searches of the Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica (Embase) and Central Register of Controlled Trials (CENTRAL) databases will be conducted. Randomised controlled trials assessing the effect of pharmacist interventions on BP among outpatients will be included. Examples for pharmacist interventions are patient education, feedback to physician and medication management. The outcome will be the change in BP or BP at follow-up or BP control. Results will be synthesised descriptively and, if appropriate, will be pooled across studies to perform meta-analyses. If feasible, we will also perform a network meta-analysis to compare interventions that have not been compared directly head-to-head by using indirect evidence. Heterogeneity in the effect will be evaluated through prespecified subgroup and stratified analyses, accounting notably for the type and intensity of interventions, patients’ characteristics and healthcare setting.Ethics and dissemination Ethical approval is not required as the results will be drawn from currently available published literature. Outcomes of the review will be shared through peer-reviewed journal and used for implementation policy.PROSPERO registration number CRD42021279751.
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spelling doaj-art-ab3d8403eab24de6aa6dd2d393595edf2025-08-20T02:17:09ZengBMJ Publishing GroupBMJ Open2044-60552022-05-0112510.1136/bmjopen-2021-059399Pharmacist interventions to improve hypertension management: protocol for a systematic review of randomised controlled trialsRoss Tsuyuki0Arnaud Chiolero1Gilles Paradis2Cinzia Del Giovane3Valérie Santschi4Viktoria Gastens5Blanche Kiszio64 Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, CanadaPopulation Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland1 Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, CanadaDepartment of Medical and Surgical Sciences for Children and Adults, University-Hospital of Modena and Reggio Emilia, Modena, Italyprofessor of health services researchInstitute of Primary Health Care (BIHAM), University of Bern, Bern, SwitzerlandLa Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, SwitzerlandIntroduction Hypertension management remains a major public health challenge in primary care. Innovative interventions to improve blood pressure (BP) control are needed. One approach is through community-based models of care with the involvement of pharmacists and other non-physician healthcare professionals. Our objective is to systematically review the evidence of the impact of pharmacist care alone or in collaboration with other healthcare professionals on BP among hypertensive outpatients compared with usual care. Because these interventions can be complex, with various components, the effect size may differ between the type of interventions. One major focus of our study will be to assess carefully the heterogeneity in the effects of these interventions to identify which ones work best in a given healthcare setting.Methods and analysis Systematic searches of the Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica (Embase) and Central Register of Controlled Trials (CENTRAL) databases will be conducted. Randomised controlled trials assessing the effect of pharmacist interventions on BP among outpatients will be included. Examples for pharmacist interventions are patient education, feedback to physician and medication management. The outcome will be the change in BP or BP at follow-up or BP control. Results will be synthesised descriptively and, if appropriate, will be pooled across studies to perform meta-analyses. If feasible, we will also perform a network meta-analysis to compare interventions that have not been compared directly head-to-head by using indirect evidence. Heterogeneity in the effect will be evaluated through prespecified subgroup and stratified analyses, accounting notably for the type and intensity of interventions, patients’ characteristics and healthcare setting.Ethics and dissemination Ethical approval is not required as the results will be drawn from currently available published literature. Outcomes of the review will be shared through peer-reviewed journal and used for implementation policy.PROSPERO registration number CRD42021279751.https://bmjopen.bmj.com/content/12/5/e059399.full
spellingShingle Ross Tsuyuki
Arnaud Chiolero
Gilles Paradis
Cinzia Del Giovane
Valérie Santschi
Viktoria Gastens
Blanche Kiszio
Pharmacist interventions to improve hypertension management: protocol for a systematic review of randomised controlled trials
BMJ Open
title Pharmacist interventions to improve hypertension management: protocol for a systematic review of randomised controlled trials
title_full Pharmacist interventions to improve hypertension management: protocol for a systematic review of randomised controlled trials
title_fullStr Pharmacist interventions to improve hypertension management: protocol for a systematic review of randomised controlled trials
title_full_unstemmed Pharmacist interventions to improve hypertension management: protocol for a systematic review of randomised controlled trials
title_short Pharmacist interventions to improve hypertension management: protocol for a systematic review of randomised controlled trials
title_sort pharmacist interventions to improve hypertension management protocol for a systematic review of randomised controlled trials
url https://bmjopen.bmj.com/content/12/5/e059399.full
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