[AF] Prescripcion por farmacéuticos

[Ramon Diaz-Alersi]

Circulation. <http://www.ncbi.nlm.nih.gov/pubmed/26063762?dopt=Abstract#> 2015
Jul 14;132(2):93-100. doi: 10.1161/CIRCULATIONAHA.115.015464. Epub 2015 Jun
10.
Randomized Trial of the Effect of Pharmacist Prescribing on Improving Blood
Pressure in the Community: The Alberta Clinical Trial in Optimizing
Hypertension (RxACTION).

.
Abstract
BACKGROUND:

Hypertension control rates remain suboptimal. Pharmacists' scope of
practice is evolving, and their position in the community may be ideal for
improving hypertension care. We aimed to study the impact of pharmacist
prescribing on blood pressure (BP) control in community-dwelling patients.
METHODS AND RESULTS:

We designed a patient-level, randomized, controlled trial, enrolling adults
with above-target BP (as defined by Canadian guidelines) through community
pharmacies, hospitals, or primary care teams in 23 communities in Alberta.
Intervention group patients received an assessment of BP and cardiovascular
risk, education on hypertension, prescribing of antihypertensive
medications, laboratory monitoring, and monthly follow-up visits for 6
months (all by their pharmacist). Control group patients received a wallet
card for BP recording, written hypertension information, and usual care
from their pharmacist and physician. Primary outcome was the change in
systolic BP at 6 months. A total of 248 patients (mean age, 64 years; 49%
male) were enrolled. Baseline mean±SD systolic/diastolic BP was
150±14/84±11 mm Hg. The intervention group had a mean±SE reduction in
systolic BP at 6 months of 18.3±1.2 compared with 11.8±1.9 mm Hg in the
control group, an adjusted difference of 6.6±1.9 mm Hg (P=0.0006). The
adjusted odds of patients achieving BP targets was 2.32 (95% confidence
interval, 1.17-4.15 in favor of the intervention).
CONCLUSIONS:

Pharmacist prescribing for patients with hypertension resulted in a
clinically important and statistically significant reduction in BP. Policy
makers should consider an expanded role for pharmacists, including
prescribing, to address the burden of hypertension.
CLINICAL TRIAL REGISTRATION:

URL: http://www.clinicaltrials.gov. Unique identifier: NCT00878566.

Tsuyuki RT
<http://www.ncbi.nlm.nih.gov/pubmed/?term=Tsuyuki%20RT%5BAuthor%5D&cauthor=true&cauthor_uid=26063762>
1, Houle SK
<http://www.ncbi.nlm.nih.gov/pubmed/?term=Houle%20SK%5BAuthor%5D&cauthor=true&cauthor_uid=26063762>
2, Charrois TL
<http://www.ncbi.nlm.nih.gov/pubmed/?term=Charrois%20TL%5BAuthor%5D&cauthor=true&cauthor_uid=26063762>
2, Kolber MR
<http://www.ncbi.nlm.nih.gov/pubmed/?term=Kolber%20MR%5BAuthor%5D&cauthor=true&cauthor_uid=26063762>
2, Rosenthal MM
<http://www.ncbi.nlm.nih.gov/pubmed/?term=Rosenthal%20MM%5BAuthor%5D&cauthor=true&cauthor_uid=26063762>
2, Lewanczuk R
<http://www.ncbi.nlm.nih.gov/pubmed/?term=Lewanczuk%20R%5BAuthor%5D&cauthor=true&cauthor_uid=26063762>
2, Campbell NR
<http://www.ncbi.nlm.nih.gov/pubmed/?term=Campbell%20NR%5BAuthor%5D&cauthor=true&cauthor_uid=26063762>
2, Cooney D
<http://www.ncbi.nlm.nih.gov/pubmed/?term=Cooney%20D%5BAuthor%5D&cauthor=true&cauthor_uid=26063762>
2, McAlister FA
<http://www.ncbi.nlm.nih.gov/pubmed/?term=McAlister%20FA%5BAuthor%5D&cauthor=true&cauthor_uid=26063762>
2; RxACTION Investigators*
<http://www.ncbi.nlm.nih.gov/pubmed/?term=RxACTION%20Investigators*%5BCorporate%20Author%5D>

© 2015 American Heart Association, Inc.
KEYWORDS:

delivery of health care; hypertension; outcome assessment (health care);
pharmacists
PMID: 26063762 [PubMed - in process]

Aquí, el texto completo:
http://circ.ahajournals.org.sci-hub.org/content/early/2015/06/10/CIRCULATIONAHA.115.015464.short

---
Ramón Díaz-Alersi