Blood Pressure Reduction by Prescribing Pharmacists Insights from the Multicentre Randomized RxEACH Study
Author(s): ,
Imran Hassa
Affiliations:
MSc
,
Charlotte Jones
Affiliations:
MD PhD
,
Brenda Hemmelgarn
Affiliations:
MD PhD
Yazid Al Hamarneh
Affiliations:
BScPharm PhD
Canadian Pharmacists Conference ePoster Library. Tsuyuki R. Jun 4, 2017; 174244
Prof. Dr. Ross Tsuyuki
Prof. Dr. Ross Tsuyuki
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Abstract
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Objectives
RxEACH was a 723 patient randomized trial of pharmacist care (including prescribing and laboratory monitoring) vs. usual care in patients at high risk for cardiovascular events (those with diabetes, chronic kidney disease (CKD), atherosclerotic vascular disease, or primary prevention Framingham Risk > 20%). In this trial, estimated risk for major cardiovascular events was reduced by 21% over 3 months in the pharmacist care group. Blood pressure (BP) reduction had a major impact on this reduction in risk. Objective: To report the effects of pharmacist care on blood pressure reduction within the RxEACH Study.

Methods
This was a prespecified subgroup analysis. We used ANCOVA to evaluate differences in change in BP from baseline to 3 months between pharmacist care and usual care groups.

Results
Overall, the contribution of BP to cardiovascular risk at baseline was 30 (SD 30)%. insert table here ΔSBP (systolic BP) and ΔDBP (diastolic BP) refer to the difference in BP between pharmacist care and usual care at 3 months, adjusted for baseline BP. Values in parentheses are 95% confidence intervals. Subgroups are not mutually exclusive.

Conclusion
In a randomized trial, application of pharmacists' advanced scope of practice resulted in clinically important BP reductions across all subgroups. These effects were greatest in those with the highest baseline BPs.

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