Debbie Rigby takes a look at what’s new in research pertaining to pharmacy
Moderate and high quality systematic reviews support the value of pharmacist-led medication review for a range of clinical outcomes, including diabetes control, blood pressure control, cholesterol, medication adherence and medication management. Significant reductions in medication and/or healthcare costs were reported in 35% of primary research studies. positive impacts on glycosylated hemoglobin, blood pressure, cholesterol, and number and appropriateness of medications were seen.
Research in Social and Administrative Pharmacy 2017;13:661–685.
A systematic review and meta-analysis of randomized controlled trials has suggested that quarter-dose combinations could provide improvements in efficacy and tolerability of blood pressure-lowering therapy. The review included 42 trials involving 20,284 participants. Single and dual quarter-dose therapy had significantly fewer adverse events compared with standard-dose monotherapy.
Hormone therapy (HT) remains the most effective treatment for vasomotor symptoms (VMS) and the genito-urinary syndrome of menopause (GSM) and has been shown to prevent bone loss and fracture. The risks of HT differ depending on type, dose, duration of use, route of administration, timing of initiation, and whether a progestogen is used. Treatment should be individualized to identify the most appropriate HT type, dose, formulation, route of administration, and duration of use, using the best available evidence to maximize benefits and minimize risks, with periodic reevaluation of the benefits and risks of continuing or discontinuing HT.
Menopause: The Journal of The North American Menopause Society 2017;24(7):000-000.
Lifelong antiplatelet treatment is recommended after ischaemic vascular events, on the basis of trials done mainly in patients younger than 75 years. A prospective population-based cohort study in patients with a first transient ischaemic attack, ischaemic stroke, or myocardial infarction treated with aspirin recommends co-prescription with PPIs to reduce the risk of major bleeding in older people. The estimated NNT for routine PPI use to prevent one disabling or fatal upper gastrointestinal bleed over 5 years fell from 338 for individuals younger than 65 years, to 25 for individuals aged 85 years or older.
The Lancet, Published Online June 13, 2017