A technology-supported collaboration between a health plan and a community pharmacy to improve blood pressure control

Meta-analysis of pharmacist-led and pharmacist-physician intervention on blood pressure control

Effective intervention is a significant component in the improvement of blood pressure control and patient adherence. Blood pressure control includes different self-monitoring techniques, mobile health monitoring, or healthcare professionals’ interventions. This study aims to compare, analyze, and interpret the effectiveness of pharmacist-physician collaboration and pharmacist- led interventions. Meta-analysis was performed using MEDLINE via PubMed, EMBASE, EBSCO, Web of Science, Scopus, and the Cochrane Library databases between 2008-2018. Of the 51 relevant systematic reviews identified, 15 were of sufficient quality and included in the data synthesis. The breakdown of the 15 included 7 (n=2026) pharmacist and 8 pharmacist-physician interventions (n=2361). The impact of pharmacist-physician collaboration and pharmacist-led interventions on Systolic Blood Pressure was –8.22 (–11.01; –5.42) (P<0.01) and –7.68 (–9.30; –6.06) (P=0.35), respectively. On the other hand, similar correlation for Diastolic Blood Pressure for the impact of pharmacist-physician collaboration and pharmacist-led interventions was –3.55 (–4.54; –2.55) (P=0.49) and –2.58 (–3.76; –1.39) (P=0.24), respectively. These results suggest that both interventions are effective for blood pressure control. However, when two meta-analyses were compared, it was found that pharmacist-physician collaboration was more effective than pharmacist-led interventions. This finding highlights the importance of multidisciplinary approaches during blood pressure control procedures. When a holistic view is considered; especially cost-effectiveness, future studies must be diversified to encompass a broader context and impact analysis.

Point-of-care testing in pharmacies-An evaluation of the service from the lens of resource-based theory of competitive advantage

BACKGROUND

Point-of-care tests (POCTs) are innovative services that are increasingly offered in community pharmacies. Assessments of these services should consider their financial sustainability in addition to their effectiveness if they are to be successful over time in a competitive environment.

OBJECTIVES

The aim of this research was to review and evaluate the POCT practice innovations literature through the lens of the resource-based theory (RBT) of competitive advantage.

DATA SOURCES

Articles describing POCT services were identified systematically through PubMed, exclusively.

STUDY SELECTION

All POCT articles in the review met the following inclusion criteria: (1) articles were published after 1999; (2) interventions were pharmacist-led innovations within a community pharmacy; (3) articles described research studies with results; and (4) articles were published in English, Spanish, or Portuguese.

DATA EXTRACTION

The RBT was operationalized using a strengths, weaknesses, opportunities, threats matrix and a business model canvas, which were employed to extract and analyze data. Articles were assessed according to the degree to which they articulated elements that the RBT needed to assess their financial sustainability in targeted markets.

RESULTS

A total of 36 articles describing POCTs and associated services were included in this review. Most of the studies reported aspects pertaining to the contextual environment of the innovation, value proposition, key activities, partners, and channels of distribution. However, the competitive dimension of the environment, as well as the cost structure and revenue streams, were often neglected in the studies.

CONCLUSIONS

The RBT is a widely tested framework that can be used for planning and reporting POCT practice innovations. On the basis of this framework, pharmacists seem to do a good job in describing how to provide POCT but fall short in explaining how these services are sustainable over time.