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. 2014 Nov 20;2014(11):CD000011. doi: 10.1002/14651858.CD000011.pub4

Chamorro 2011.

Methods Randomized controlled trial
Participants The study location was in 9 community pharmacies of Granada, Spain
44 participants were randomized to the intervention group and 41 participants were randomized to the control group
The inclusion criteria were patient presenting to the pharmacy to file a prescription in their name for one or more of antihypertensives, anti‐dyslipidemia, cardiovascular prevention, antidiabetics at moderate or high CV risk
The exclusion criteria were BP > 180/110, history of MI within 3 months, on cardiac rehabilitation, terminally ill, low CV risk, refusing consent. They were excluded if their physician prescriber did not see fit to include them in the pharmacotherapy follow‐up
Interventions Intervention: PHARMACOTHERAPY FOLLOW‐UP
 The intervention consisted of follow‐up of the patients by the pharmacist. He gave written and oral information about cardiovascular prevention and adherence to the patients in the first interview. The pharmacist adopted a pharmacotherapy follow‐up program, for 4 visits over 16 to 18 weeks. The final assessment was at 32 weeks
Control: EDUCATION
 This procedure consisted of health education, written and oral material all given in 1 session at enrollment
Outcomes The measure of adherence was the Morisky‐Green‐Levine (MGL) test. A patient was considered adherent when they answered all questions correctly. Adherence was measured at baseline, 16 weeks, and 32 weeks in the control group and the intervention group by a pharmacist. Adherence in each group was calculated in terms of the percentage of patients who were achievers with the therapy
The patient outcomes were blood pressure and cholesterol level. Blood pressure was considered to have achieved the therapeutic goal when values were under 140/90 mm Hg, or under 130/80 mm Hg in patients with diabetes, renal failure and acute myocardial infarction. Cholesterol levels were considered to have achieved the therapeutic goal in primary prevention when values were under 200 mg/dl and in secondary prevention under 175 mg/dl. The measures were made for control group at baseline, 16 weeks, and 32 weeks. The intervention group was assessed at the baseline, 2 to 4 weeks, 6 to 8 weeks, 16 to 18 weeks, and 32 weeks.They were made by the same pharmacist
Notes
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Insufficient information provided about the sequence generation process
Allocation concealment (selection bias) Low risk Centralized randomization
Selective reporting (reporting bias) Unclear risk Protocol not available
Other bias Unclear risk The information in the article was insufficient to determine if there were other types of bias
Blinding of outcome assessment (detection bias) 
 Adherence measure Unclear risk (PRIMARY) SELF REPORT ‐ QUESTIONNAIRE MGL ‐ Blinding not mentioned; self report
Blinding of outcome assessment (detection bias) 
 Patient outcome Unclear risk (PRIMARY) BLOOD PRESSURE ‐ No blinding statement
Blinding of participants (performance bias) 
 Adherence measure High risk (PRIMARY) SELF REPORT ‐ QUESTIONNAIRE MGL ‐ self report ‐ subjective measure ‐ patient not blinded
Blinding of participants (performance bias) 
 Patient outcome Unclear risk (PRIMARY) BLOOD PRESSURE ‐ No blinding statement
Blinding of personnel (performance bias) 
 Adherence measure Unclear risk (PRIMARY) SELF REPORT ‐ QUESTIONNAIRE MGL ‐ Blinding not mentioned; self report
Blinding of personnel (performance bias) 
 Patient outcome Unclear risk (PRIMARY) BLOOD PRESSURE ‐ No blinding statement
Incomplete outcome data (attrition bias) 
 Adherence measure Unclear risk (PRIMARY) SELF REPORT ‐ QUESTIONNAIRE MGL ‐ Missing data not reported
Incomplete outcome data (attrition bias) 
 Patient outcome Unclear risk (PRIMARY) BLOOD PRESSURE ‐ Not reported