Evidence map›Paper›PMID 17452390›Full record

Trial reportBMJ (Clinical research ed.)2007

Effectiveness of visits from community pharmacists for patients with heart failure: HeartMed randomised controlled trial.

Richard Holland, Iain Brooksby, Elizabeth Lenaghan, Kate Ashton, Laura Hay, Richard Smith, Lee Shepstone, Alistair Lipp, Clare Daly, Amanda Howe and 2 more

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 15 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
52citing papers in PubMed, 15 pooled it
10.5field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

52 citing papers in PubMed, 15 syntheses or guidelines pooled it, 174 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Disease management interventions for heart failure.The Cochrane database of systematic reviews · 2019
    Pooled it
  8. Pooled it
  9. Improving Treatment Adherence in Heart Failure.Deutsches Arzteblatt international · 2016
    Pooled it
  10. Pooled it
  11. Pooled it
  12. Pooled it
  13. Interventions for enhancing medication adherence.The Cochrane database of systematic reviews · 2014
    Pooled it
  14. Pooled it
  15. Pooled it
  16. Trial
  17. Trial
  18. Trial
  19. Trial
  20. Trial
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 1 country.

Richard HollandClinical Trials Unit, School of Medicine, Health Policy and Practice, University of East Anglia, Norwich NR4 7TJ. r.holland@uea.ac.uk
Iain Brooksby
Elizabeth Lenaghan
Kate Ashton
Laura Hay
Richard Smith
Lee Shepstone
Alistair Lipp
Clare Daly
Amanda Howe
Roger Hall
Ian Harvey
University of East Anglia · GBGreat Yarmouth College · GBNHS Lothian · GBNorfolk and Norwich University Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo test whether a drug review and symptom self management and lifestyle advice intervention by community pharmacists could reduce hospital admissions or mortality in heart failure patients.

designRandomised controlled trial.

settingHome based intervention in heart failure patients.

participants293 patients diagnosed with heart failure were included (149 intervention, 144 control) after an emergency admission.

interventionTwo home visits by one of 17 community pharmacists within two and eight weeks of discharge. Pharmacists reviewed drugs and gave symptom self management and lifestyle advice. Controls received usual care.

main outcome measuresThe primary outcome was total hospital readmissions at six months. Secondary outcomes included mortality and quality of life (Minnesota living with heart failure questionnaire and EQ-5D).

resultsPrimary outcome data were available for 291 participants (99%). 136 (91%) intervention patients received one or two visits. 134 admissions occurred in the intervention group compared with 112 in the control group (rate ratio=1.15, 95% confidence interval 0.89 to 1.48; P=0.28, Poisson model). 30 intervention patients died compared with 24 controls (hazard ratio=1.18, 0.69 to 2.03; P=0.54). Although EQ-5D scores favoured the intervention group, Minnesota living with heart failure questionnaire scores favoured controls; neither difference was statistically significant.

conclusionThis community pharmacist intervention did not lead to reductions in hospital admissions in contrast to those found in trials of specialist nurse led interventions in heart failure. Given that heart failure accounts for 5% of hospital admissions, these results present a problem for policy makers who are faced with a shortage of specialist provision and have hoped that skilled community pharmacists could produce the same benefits. TRIAL REGISTRATION NUMBER: ISRCTN59427925.

Indexed as

Community Pharmacy ServicesHeart FailureHome Care ServicesHospitalizationHouse CallsHumansPatient ComplianceQuality of LifeTreatment Outcome

Identifiers

PMID17452390
PMCPMC1877883
OpenAlexW2161374495

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.