OBJECTIVES

: Because of their role in medication dispensing, pharmacists are ideally positioned to promote optimal use and assess adherence of prescribed medications in patients with chronic diseases. We sought to conduct a systematic review of randomized control trials (RCTs) to ascertain the effectiveness of pharmacist intervention to improve outcomes in hypertension patients, including blood pressure control and medication adherence.

METHODS

: PubMed, Web of Science, Elsevier, EBSCO Host/ CINAHL, Google Scholar were searched for English-language articles published between January 1, 1995, and October 31, 2018. Cochrane Collaboration’s tool was used to assess the risk of bias in the RCTs. Relevant data on study design, population demographics, interventions, adherence measurement tools, outcomes, follow up time, methodological quality, and external validity were tabulated.

RESULTS

: A total of 35 RCTs were identified for this review. RCTs were limited to adult patients (≥ 18 years of age) with a diagnosis of hypertension (BP ≥ 130/80 or patient taking antihypertensive medications). The extent of pharmacist interventions varied among trials and included, medication counseling, patient education, distribution of educational materials, telemonitoring of blood pressure, individualized care plans, and check-in meetings. Majority of trials (n=29) showed statistically significant improvement in blood pressure in the intervention groups at follow-up. Of the 35 RCTs, 20 included an assessment of medication adherence. A few trials (n=9) showed statistically significant improvement in medication adherence in patients receiving additional pharmaceutical care. None of the RCTs was considered to have a high risk of bias.

CONCLUSIONS

: The review indicates a potential benefit of pharmacist interventions to improve patients’ outcomes and medication adherence in hypertension through counseling and education. Future research is needed to determine the most effective pharmacist interventions in managing high blood pressure and to assess the cost-effectiveness of these interventions.