Pharmacist interventions in hypertension care: Network meta-analysis to identify what works best

Abstract Background Hypertension management remains a major public health challenge. Recent hypertension guidelines recommend the involvement of pharmacists and other nonphysician healthcare providers for team-based care management. Nevertheless, implementation of pharmacist interventions is lacking and knowledge of which interventions work best is needed. We are therefore performing a network meta-analysis to compare the effectiveness of different pharmacist interventions on blood pressure (BP) among outpatients with hypertension. Methods We have completed systematic searches of randomized controlled trials assessing the effect of pharmacist interventions, alone or in collaboration, on BP among outpatients with hypertension compared to usual care. The outcome was the change in systolic and diastolic BP. We compared the effectiveness of different types of pharmacist interventions based on the Cochrane Effective Practice and Organisation of Care (EPOC) classification. The systematic review with simple pairwise meta-analysis is registered in PROSPERO (CRD42021279751) and published in an open-access peer-reviewed journal. Network meta-analysis with random effects is ongoing to identify which interventions worked best to decrease BP. Results Out of 2,330 study records identified by searches of electronic databases, we included 95 studies, with 31,168 participants, published between 1973 and 2023. Pharmacist interventions included patient education in 88%, feedback to healthcare providers in 49%, and patient reminders in 24% of the studies. Meta-analysis showed a reduction of − 5.3 mmHg (95% CI: −6.3 to − 4.4; I2 = 86%) in systolic BP and −2.3 mmHg (95% CI: −2.9 to − 1.8; I2 = 75%) in diastolic BP. The network meta-analysis is ongoing and results will be presented at the congress. Conclusions Pharmacist interventions were on average effective to decrease BP. This network meta-analysis aims to identify which type of pharmacist interventions work best to improve hypertension management. Key messages • Recent hypertension guidelines recommend pharmacist involvement in hypertension care management. • This network meta-analysis aims to identify which type of pharmacist interventions in hypertension management work best.