A Systematic Review of the Evidence for Pharmacist Care of Patients With Dyslipidemia
Bibliographic record
Abstract
STUDY OBJECTIVE: To evaluate the effect of pharmacist care on patients with dyslipidemia. DESIGN: Systematic review of 21 randomized controlled trials. PATIENTS: A total of 5416 patients who received enhanced pharmacist care or standard care as part of a research study. MEASUREMENTS AND MAIN RESULTS: Nineteen databases and four trial registries were systematically searched from inception through February 21, 2010, with an update in September 2011. In addition, Web sites of relevant professional associations, scientific meetings, and research groups were reviewed, and manual searches of select journals were performed. A total of 8771 articles were identified, and 21 studies included. Data from the studies were analyzed using a random-effects model. The primary outcome measure assessed was the difference between the groups (pharmacist intervention vs standard care) in low-density lipoprotein cholesterol (LDL) level at the end of follow-up. Secondary outcome measures included the difference between the groups at the end of follow-up in total cholesterol, high-density lipoprotein cholesterol, and triglyceride levels; and the proportion of patients who achieved target lipid parameters, underwent lipid panel measurements, adhered to therapy, and/or were instructed to change their lipid-lowering therapy. At the end of follow-up, the mean LDL level was 10.7 mg/dl lower in the enhanced pharmacy care groups compared with the standard care groups (95% confidence interval [CI] -16.9 to -4.6 mg/dl), with moderate heterogeneity. The mean total cholesterol level was significantly lower in the enhanced pharmacy care groups compared with the standard care groups; however, these results were highly heterogeneous. Patients who received enhanced pharmacist care were also more likely than those receiving standard care to achieve target lipid parameters (odds ratio [OR] 2.46, 95% CI 1.43-4.25) and to have a lipid panel ordered or recommended by a pharmacist during the study (OR 2.05, 95% CI 1.30-3.24). Patients in the pharmacist intervention groups were almost twice as likely as patients in the standard care groups to have a change in lipid-lowering therapy (OR 1.82, 95% CI 1.09-3.06). Adherence data could not be analyzed. CONCLUSION: This systematic review showed that enhanced pharmacist care improves lipid parameters, notably LDL levels, in patients with dyslipidemia. These results point to the benefit that pharmacist care can provide across the spectrum of dyslipidemia management, from screening patients to treating them to assisting them in the attainment of clinical targets.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.081 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.013 | 0.010 |
| Bibliometrics | 0.008 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".