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药师对高血压患者血压控制的远程随访:随机对照试验的系统评价和荟萃分析。

Remote follow-up by pharmacists for blood pressure control in patients with hypertension: a systematic review and a meta-analysis of randomized controlled trials.

机构信息

Department of Pharmacotherapeutics and Informatics, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-Cho, Toyoake, Aichi, 470-1192, Japan.

Sugi Pharmacy Co., Ltd., Obu, Aichi, Japan.

出版信息

Sci Rep. 2024 Jan 30;14(1):2535. doi: 10.1038/s41598-024-52894-8.

Abstract

Hypertension is a major cause of cardiovascular diseases. Several recent studies reported that pharmacists' remote follow-up reduced hypertension patients' blood pressure (BP). This meta-analysis aims to verify whether remote follow-up by pharmacists improves BP levels and reveal the factors that make the intervention effective. The search, conducted using PubMed/Medline, Embase, and Cochrane Library from June to July 2023, targeted articles published between October 1982 and June 2023, using terms including "pharmacist", "hypertension", and "randomized controlled trial (RCT)". The inclusion criteria were: (a) RCTs involving hypertension patients with or without comorbidities, (b) pharmacists using remote communication tools to conduct follow-up encounter during the intervention period, (c) reporting systolic blood pressure (SBP) at baseline and during intervention. SBP was the primary outcome for the meta-analysis. Thirteen studies (3969 participants) were included in this meta-analysis. The mean difference of SBP between intervention group and control group was - 7.35 mmHg (P < 0.0001). Subgroup analyses showed the greater reduction of SBP in the "regularly scheduled follow-up cohort" (- 8.89 mmHg) compared with the "as needed follow-up cohort" (- 3.23 mmHg, P < 0.0001). The results revealed that remote follow-up by pharmacists reduced SBP levels in hypertension patients and scheduled remote follow-up may contribute to the effectiveness.

摘要

高血压是心血管疾病的主要病因。最近有几项研究报告称,药剂师的远程随访降低了高血压患者的血压(BP)。本荟萃分析旨在验证药剂师的远程随访是否能改善血压水平,并揭示使干预有效的因素。检索使用了 PubMed/Medline、Embase 和 Cochrane Library,检索时间为 2023 年 6 月至 7 月,目标是 1982 年 10 月至 2023 年 6 月期间发表的文章,使用的术语包括“药剂师”、“高血压”和“随机对照试验(RCT)”。纳入标准为:(a)RCT 研究涉及有或无合并症的高血压患者,(b)药剂师使用远程通讯工具在干预期间进行随访,(c)报告基线和干预期间的收缩压(SBP)。SBP 是荟萃分析的主要结局。本荟萃分析共纳入了 13 项研究(3969 名参与者)。干预组和对照组之间 SBP 的平均差值为-7.35mmHg(P<0.0001)。亚组分析显示,“定期随访队列”的 SBP 降低幅度更大(-8.89mmHg),而“按需随访队列”的 SBP 降低幅度较小(-3.23mmHg,P<0.0001)。结果表明,药剂师的远程随访降低了高血压患者的 SBP 水平,定期远程随访可能有助于提高干预效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e42/10827741/00173b76a5a8/41598_2024_52894_Fig1_HTML.jpg

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