Surya Geraldo, Insani Widya Norma
Department of Pharmacology and Clinical Pharmacy, Universitas Padjadjaran, Sumedang, Indonesia.
Centre of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Sumedang, Indonesia.
J Multidiscip Healthc. 2025 Aug 27;18:5275-5287. doi: 10.2147/JMDH.S530575. eCollection 2025.
With the advancement of digital technologies, pharmacist-led digital health interventions (DHI) have emerged as a promising strategy to improve hypertension management. This systematic review evaluated randomized controlled trials (RCTs) published from December 1996 to May 2024, identified via PubMed by incorporating key concepts including DHIs, pharmaceutical care, and hypertension. The review included RCTs assessed telephone-, web-, or mobile-based pharmacist-led DHI compared to usual care (UC). Primary outcomes included blood pressure (BP) reduction, medication adherence, and identification of drug-related problems (DRPs). Following the modified Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, fourteen RCTs met inclusion criteria, with interventions categorized as telephone monitoring (n = 6), web-based interventions (n = 5), and mobile-based interventions (n = 3). Eight studies (57.14%) showed significant BP reduction in the intervention group (IG), one (7.14%) reported diastolic blood pressure (DBP) reduction only, and one found no significant BP difference between IG and control group (CG). One study reported a higher BP control rate in the IG (OR = 3.64). All studies evaluating adherence (n = 5) showed improvements, and one reported enhanced DRP identification. We identified that interventions' effectiveness is influenced by frequency of the intervention, personalization, and patient engagement. Designing an intervention compatible with each patient and providing sufficient guidance may improve effectiveness. As most studies were conducted in high-income countries, further research is needed to ensure the applicability of DHIs in diverse settings. In conclusion, pharmacist-led DHIs demonstrate potential in improving hypertension outcomes, with further validation required to support their implementation across varied healthcare systems.
随着数字技术的进步，由药剂师主导的数字健康干预措施（DHI）已成为改善高血压管理的一项有前景的策略。本系统评价评估了1996年12月至2024年5月发表的随机对照试验（RCT），通过在PubMed中纳入包括DHI、药学服务和高血压等关键概念进行检索。该评价纳入了评估由药剂师主导的基于电话、网络或移动设备的DHI并与常规护理（UC）进行比较的RCT。主要结局包括血压降低、用药依从性以及药物相关问题（DRP）的识别。按照修改后的系统评价和Meta分析优先报告条目（PRISMA）指南，14项RCT符合纳入标准，干预措施分为电话监测（n = 6）、基于网络的干预（n = 5）和基于移动设备的干预（n = 3）。八项研究（57.14%）显示干预组（IG）血压显著降低，一项研究（7.14%）仅报告舒张压（DBP）降低，一项研究发现IG与对照组（CG）之间血压无显著差异。一项研究报告IG的血压控制率更高（OR = 3.64）。所有评估依从性的研究（n = 5）均显示有改善，一项研究报告DRP识别有所增强。我们发现干预措施的有效性受干预频率、个性化程度和患者参与度的影响。设计与每位患者相适配的干预措施并提供充分指导可能会提高有效性。由于大多数研究在高收入国家进行，因此需要进一步研究以确保DHI在不同环境中的适用性。总之，由药剂师主导的DHI在改善高血压结局方面显示出潜力，但需要进一步验证以支持其在不同医疗系统中的实施。
