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Effectiveness of the pharmacist-involved multidisciplinary management of heart failure to improve hospitalizations and mortality rates in 4630 patients: a systematic review and meta-analysis of randomized controlled trials

Parajuli, DR, Kourbelis, C, Franzon, J, Newman, P, Mckinnon, RA, Shakib, S, Whitehead, D ORCID: 0000-0003-4131-4594 and Clark, DA 2019 , 'Effectiveness of the pharmacist-involved multidisciplinary management of heart failure to improve hospitalizations and mortality rates in 4630 patients: a systematic review and meta-analysis of randomized controlled trials' , Journal of Cardiac Failure, vol. 25, no. 9 , pp. 744-756 , doi: 10.1016/j.cardfail.2019.07.455.

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Abstract

Background: There is evidence that heart failure (HF) patients who receive pharmacist care have better clinical outcomes. Methods and results: English-language peer-reviewed randomized controlled trials comparing the pharmacist-involved multidisciplinary intervention with usual care were included. We searched PubMed, MEDLINE, EMBASE, CINAHL, Web of Science, Scopus, and the Cochrane Library from inception through March 2017. Cochrane method for risk of bias was used to assess within and between studies. 18 RCTs (n = 4630) were included for systematic review, and 16 (n = 4447) for meta-analysis. Meta-analysis showed a significant reduction in HF hospitalizations {odds ratio (OR) 0.72 [95% confidence interval (CI) 0.55-0.93], P = .01, I2 = 39%} but no effect on HF mortality. Similarly, a significant reduction in all-cause hospitalizations [OR 0.76, 95% CI (0.60-0.96), P = .02, I2 = 52%] but no effect on all-cause mortality was revealed. The overall trend was an improvement in medication adherence. There were significant improvements in HF knowledge (P Conclusions: The pharmacist is a vital member of a multidisciplinary team in HF management to improve clinical outcomes. There was a great deal of variability about which specific intervention is most effective in improving clinical outcomes.

Item Type: Article
Authors/Creators:Parajuli, DR and Kourbelis, C and Franzon, J and Newman, P and Mckinnon, RA and Shakib, S and Whitehead, D and Clark, DA
Keywords: heart failure, hospitalization, meta-analysis, mortality, multidisciplinary team, pharmacist
Journal or Publication Title: Journal of Cardiac Failure
Publisher: Churchill Livingstone Inc Medical Publishers
ISSN: 1071-9164
DOI / ID Number: 10.1016/j.cardfail.2019.07.455
Copyright Information:

© 2019 Elsevier Inc. All rights reserved.

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