A pharmaceutical interview improves clinical outcomes: a randomized
controlled study on hypertension, type 2 diabetes and
hypercholesterolemia.
Abstract
Aims: These last years, pharmacists gained more and more importance in
the clinical support of patients. However, few studies have explored the
clinical outcomes of a pharmaceutical intervention on chronic patients.
Methods: A randomized controlled study single blinded, evaluating the
impact of a single pharmaceutical interview on hypertension, type 2
diabetes and hypercholesterolemia patients not reaching the therapeutic
objectives despite a drug therapy. Patients in the intervention group
were interviewed by a pharmacist who provided patient education on
pathology management and advice on how to deal with the pathology on a
daily basis, and identified any prescription problems. The primary
outcome was the proportion of patients reaching the therapeutic
objectives for blood pressure, glycated hemoglobin level and low-density
lipoprotein cholesterol level at the three-month follow up consultation.
Results: Seventy-three patients completed the study. In the control
group, 33.3% patients reached the therapeutic objectives with the usual
care versus 61.7% in the intervention group (p=0.015). The intervention
was significantly more effective on patients with more than five
different drugs prescribed (+16.7% vs +60.0%; p=0.005) and with a high
education level (+29.4% vs +68.8%; p=0.024). A much lower rate of type
2 diabetes patients reached the therapeutic objectives whatever the
group. Interestingly, the efficacy of the intervention did not depend on
the number of chronic diseases or age after adjustment for the number of
different drugs prescribed. Conclusions: There is a concrete clinical
and public health impact of a single pharmaceutic interview, especially
on polypharmacy patients with hypertension or hypercholesterolemia.