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Open Access Research article

Pharmacist care and the management of coronary heart disease: a systematic review of randomized controlled trials

Hongwen Cai1, Haibin Dai2, Yangmin Hu2, Xiaofeng Yan2 and Huimin Xu2*

Author Affiliations

1 Department of Cardiovascular Medicine, First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310006, China

2 Department of Pharmacy, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, China

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BMC Health Services Research 2013, 13:461  doi:10.1186/1472-6963-13-461

Published: 4 November 2013

Abstract

Background

Secondary prevention is important for reducing both mortality and morbidity of patients with coronary heart disease (CHD). Pharmacists can provide medication and also work on disease management for patients with CHD. This review has been carried out to evaluate the role of pharmacist care on mortality, morbidity, and the CHD management.

Methods

The PubMed, MEDLINE, EMBASE, Web of Science and Cochrane Central Register of Controlled Trials databases were searched for randomized controlled trials (RCTs) to evaluate the impact of pharmacist care interventions on patients with CHD (in both community and hospital settings). Primary outcomes of interest were mortality, cardiovascular events and hospitalizations. Secondary outcomes were medication adherence, blood pressure control, and lipid management.

Results

Five RCTs (2568 patients) were identified. The outcomes were mortality, cardiovascular events, and hospitalizations in one study (421 patients), medication adherence in five studies, blood pressure in two studies (1914 patients), and lipid management in three studies (932 patients). The interventions of pharmacists included patient education, medication management, feedback to health care professionals, and disease management. There was no significant effect of pharmacist care on mortality, recurrent cardiac events or hospitalization of CHD patients. Significant positive effects of pharmacist care were shown on medication adherence in three studies, on blood pressure control in one study and on lipid management in one study.

Conclusion

In this study, we concluded that pharmacists have a beneficial role in the care of CHD patients, although the evidence supporting positive impacts on mortality and morbidity remains uncertain due to the unavailability of data in these areas. Further research is needed to discern the contribution of pharmacist care on hard endpoints of CHD.

Keywords:
Coronary heart disease; Pharmacist; Secondary prevention; Mortality; Medication adherence