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

Abstract:

OBJECTIVE:To 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. DESIGN:Randomised controlled trial. SETTING:Home based intervention in heart failure patients. PARTICIPANTS:293 patients diagnosed with heart failure were included (149 intervention, 144 control) after an emergency admission. INTERVENTION:Two 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 MEASURES:The 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). RESULTS:Primary 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. CONCLUSION:This 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.

journal_name

BMJ

authors

Holland R,Brooksby I,Lenaghan E,Ashton K,Hay L,Smith R,Shepstone L,Lipp A,Daly C,Howe A,Hall R,Harvey I

doi

10.1136/bmj.39164.568183.AE

subject

Has Abstract

pub_date

2007-05-26 00:00:00

pages

1098

issue

7603

eissn

0959-8138

issn

1756-1833

pii

bmj.39164.568183.AE

journal_volume

334

pub_type

杂志文章,随机对照试验
  • Psychosis with good prognosis in Afro-Caribbean people now living in the United Kingdom.

    abstract:OBJECTIVES:To compare the course and outcome of psychotic illness in a group of Afro-Caribbean patients resident in the United Kingdom and a group of white British patients. DESIGN:Cohort study of consecutive admissions followed up for four years. SUBJECTS:113 patients with psychotic illness of recent onset admitted ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.311.7016.1325

    authors: McKenzie K,van Os J,Fahy T,Jones P,Harvey I,Toone B,Murray R

    更新日期:1995-11-18 00:00:00

  • Changing to generic formulary: how one fundholding practice reduced prescribing costs.

    abstract:OBJECTIVES:To observe one general practice's attempt to reduce prescribing costs on becoming third wave fundholders through the introduction of a generic formulary applied to all new and repeat prescribing. To assess the impact on patients and prescribing patterns. DESIGN:An observational study using interviews with p...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.310.6978.505

    authors: Dowell JS,Snadden D,Dunbar JA

    更新日期:1995-02-25 00:00:00

  • Prognostic models for outcome prediction in patients with chronic obstructive pulmonary disease: systematic review and critical appraisal.

    abstract:OBJECTIVE:To map and assess prognostic models for outcome prediction in patients with chronic obstructive pulmonary disease (COPD). DESIGN:Systematic review. DATA SOURCES:PubMed until November 2018 and hand searched references from eligible articles. ELIGIBILITY CRITERIA FOR STUDY SELECTION:Studies developing, valid...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析

    doi:10.1136/bmj.l5358

    authors: Bellou V,Belbasis L,Konstantinidis AK,Tzoulaki I,Evangelou E

    更新日期:2019-10-04 00:00:00

  • Telephone or internet delivered talking therapy can alleviate irritable bowel symptoms.

    abstract::The studyEveritt H, Landau G, Little P. Therapist telephone-delivered CBT and web-based CBT compared with treatment as usual in refractory irritable bowel syndrome: the ACTIB three-arm RCT. Health Technol Assess 2019;23:1-154.This project was funded by the NIHR Health Technology Assessment Programme (project number 11...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 评论,杂志文章

    doi:10.1136/bmj.l4962

    authors: Cook R,Davidson P,Martin R,NIHR Dissemination Centre.

    更新日期:2019-11-04 00:00:00

  • Pity the poor gatekeeper: a transatlantic perspective on cost containment in clinical practice.

    abstract::This paper summarizes the key findings of a U.S. study of 48 primary care physicians acting as gatekeepers in a large health maintenance organization to determine the effects of their cost containment role on the doctor patient relationship. Taylor highlights some of the findings and conclusions that he believes are ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.299.6711.1323

    authors: Taylor TR

    更新日期:1989-11-25 00:00:00

  • The earliest days of first aid.

    abstract::First aid, as a profession in its own right, has a history of only 120 years. It evolved from the teachings of the Royal Humane Society and military surgeons, who saw the wisdom of training in splinting and bandaging for battlefield wounds. In 1878 two Aberdeenshire military officers, Surgeon-Major Peter Shepherd of t...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 传,历史文章,杂志文章

    doi:10.1136/bmj.309.6970.1718

    authors: Pearn J

    更新日期:1994-12-24 00:00:00

  • Comparison of elderly people's technique in using two dry powder inhalers to deliver zanamivir: randomised controlled trial.

    abstract:OBJECTIVE:To determine whether elderly people can learn to use the inhaler used to deliver zanamivir (Relenza Diskhaler) as effectively as the Turbohaler and to identify which aspects of inhaler technique are most problematic. DESIGN:Randomised, controlled, intervention study. SETTING:Wards for acute elderly care in ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.322.7286.577

    authors: Diggory P,Fernandez C,Humphrey A,Jones V,Murphy M

    更新日期:2001-03-10 00:00:00

  • Weight growth in infants born to mothers who smoked during pregnancy.

    abstract:OBJECTIVE:To determine whether maternal smoking during pregnancy causes impairment in growth after birth. DESIGN:Longitudinal study. SETTING:Six medical university centres of six towns of north, central, and south Italy. SUBJECTS:12,987 babies (10,238 born from non-smoking mothers, 2276 from mothers smoking one to n...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.310.6982.768

    authors: Conter V,Cortinovis I,Rogari P,Riva L

    更新日期:1995-03-25 00:00:00

  • Continuing medical education: experience and opinions of consultants.

    abstract::The right of consultants to study leave and expenses is not binding on trusts and has been eroded in directly managed units. Complaints led to a survey of consultants in North West Thames region. This showed that most consultants use their own time and money to maintain their knowledge by buying and consulting journal...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.306.6889.1398

    authors: Kerr DN,Jones SA,Easmon CS

    更新日期:1993-05-22 00:00:00

  • Parenteral dexamethasone for acute severe migraine headache: meta-analysis of randomised controlled trials for preventing recurrence.

    abstract:OBJECTIVE:To examine the effectiveness of parenteral corticosteroids for the relief of acute severe migraine headache and prevention of recurrent headaches. DESIGN:Meta-analysis. DATA SOURCES:Electronic databases (Cochrane Central Register of Controlled Trials, Medline, Embase, LILACS, and CINAHL), conference proceed...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1136/bmj.39566.806725.BE

    authors: Colman I,Friedman BW,Brown MD,Innes GD,Grafstein E,Roberts TE,Rowe BH

    更新日期:2008-06-14 00:00:00

  • Effect of routine zinc supplementation on pneumonia in children aged 6 months to 3 years: randomised controlled trial in an urban slum.

    abstract:OBJECTIVES:To evaluate the effect of daily zinc supplementation in children on the incidence of acute lower respiratory tract infections and pneumonia. DESIGN:Double masked, randomised placebo controlled trial. SETTING:A slum community in New Delhi, India. PARTICIPANTS:2482 children aged 6 to 30 months. INTERVENTIO...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.324.7350.1358

    authors: Bhandari N,Bahl R,Taneja S,Strand T,Mølbak K,Ulvik RJ,Sommerfelt H,Bhan MK

    更新日期:2002-06-08 00:00:00

  • Effect on peer review of telling reviewers that their signed reviews might be posted on the web: randomised controlled trial.

    abstract:OBJECTIVES:To see whether telling peer reviewers that their signed reviews of original research papers might be posted on the BMJ's website would affect the quality of their reviews. DESIGN:Randomised controlled trial. SETTING:A large international general medical journal based in the United Kingdom. PARTICIPANTS:54...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,随机对照试验

    doi:10.1136/bmj.c5729

    authors: van Rooyen S,Delamothe T,Evans SJ

    更新日期:2010-11-16 00:00:00

  • Childhood energy intake and adult mortality from cancer: the Boyd Orr Cohort Study.

    abstract:OBJECTIVE:To examine the relation between energy intake in childhood and adult mortality from cancer. STUDY DESIGN:Cohort study. SETTING:16 rural and urban centres in England and Scotland. SUBJECTS:3834 people who took part in Lord Boyd Orr's Carnegie survey of family diet and health in prewar Britain between 1937 a...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.316.7130.499

    authors: Frankel S,Gunnell DJ,Peters TJ,Maynard M,Davey Smith G

    更新日期:1998-02-14 00:00:00

  • Insulin pump therapy, multiple daily injections, and cardiovascular mortality in 18,168 people with type 1 diabetes: observational study.

    abstract:OBJECTIVE:To investigate the long term effects of continuous subcutaneous insulin infusion (insulin pump therapy) on cardiovascular diseases and mortality in people with type 1 diabetes. DESIGN:Observational study. SETTING:Swedish National Diabetes Register, Sweden 2005-12. PARTICIPANTS:18,168 people with type 1 dia...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.h3234

    authors: Steineck I,Cederholm J,Eliasson B,Rawshani A,Eeg-Olofsson K,Svensson AM,Zethelius B,Avdic T,Landin-Olsson M,Jendle J,Gudbjörnsdóttir S,Swedish National Diabetes Register.

    更新日期:2015-06-22 00:00:00

  • Association between alcohol and cardiovascular disease: Mendelian randomisation analysis based on individual participant data.

    abstract:OBJECTIVE:To use the rs1229984 variant in the alcohol dehydrogenase 1B gene (ADH1B) as an instrument to investigate the causal role of alcohol in cardiovascular disease. DESIGN:Mendelian randomisation meta-analysis of 56 epidemiological studies. PARTICIPANTS:261 991 individuals of European descent, including 20 259 c...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析

    doi:10.1136/bmj.g4164

    authors: Holmes MV,Dale CE,Zuccolo L,Silverwood RJ,Guo Y,Ye Z,Prieto-Merino D,Dehghan A,Trompet S,Wong A,Cavadino A,Drogan D,Padmanabhan S,Li S,Yesupriya A,Leusink M,Sundstrom J,Hubacek JA,Pikhart H,Swerdlow DI,Panayiotou

    更新日期:2014-07-10 00:00:00

  • Mumps, measles, and rubella vaccine and the incidence of autism recorded by general practitioners: a time trend analysis.

    abstract:OBJECTIVE:To estimate changes in the risk of autism and assess the relation of autism to the mumps, measles, and rubella (MMR) vaccine. DESIGN:Time trend analysis of data from the UK general practice research database (GPRD). SETTING:General practices in the United Kingdom. SUBJECTS:Children aged 12 years or younger...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.322.7284.460

    authors: Kaye JA,del Mar Melero-Montes M,Jick H

    更新日期:2001-02-24 00:00:00

  • Re-evaluation of link between interpregnancy interval and adverse birth outcomes: retrospective cohort study matching two intervals per mother.

    abstract:OBJECTIVE:To re-evaluate the causal effect of interpregnancy interval on adverse birth outcomes, on the basis that previous studies relying on between mother comparisons may have inadequately adjusted for confounding by maternal risk factors. DESIGN:Retrospective cohort study using conditional logistic regression (mat...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.g4333

    authors: Ball SJ,Pereira G,Jacoby P,de Klerk N,Stanley FJ

    更新日期:2014-07-23 00:00:00

  • Written informed consent and selection bias in observational studies using medical records: systematic review.

    abstract:OBJECTIVES:To determine whether informed consent introduces selection bias in prospective observational studies using data from medical records, and consent rates for such studies. DESIGN:Systematic review. DATA SOURCES:Embase, Medline, and the Cochrane Library up to March 2008, reference lists from pertinent article...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,评审

    doi:10.1136/bmj.b866

    authors: Kho ME,Duffett M,Willison DJ,Cook DJ,Brouwers MC

    更新日期:2009-03-12 00:00:00

  • Exposure to diagnostic radiation and risk of breast cancer among carriers of BRCA1/2 mutations: retrospective cohort study (GENE-RAD-RISK).

    abstract:OBJECTIVE:To estimate the risk of breast cancer associated with diagnostic radiation in carriers of BRCA1/2 mutations. DESIGN:Retrospective cohort study (GENE-RAD-RISK). SETTING:Three nationwide studies (GENEPSO, EMBRACE, HEBON) in France, United Kingdom, and the Netherlands, PARTICIPANTS:1993 female carriers of BRC...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.e5660

    authors: Pijpe A,Andrieu N,Easton DF,Kesminiene A,Cardis E,Noguès C,Gauthier-Villars M,Lasset C,Fricker JP,Peock S,Frost D,Evans DG,Eeles RA,Paterson J,Manders P,van Asperen CJ,Ausems MG,Meijers-Heijboer H,Thierry-Chef I,Hau

    更新日期:2012-09-06 00:00:00

  • Other cities, same problems.

    abstract::London's health care problems, particularly underfunding, are mirrored in other major cities in the United Kingdom and abroad. None has found the perfect solution, but the debates on the Tomlinson report provide an opportunity to review how to manage the three major areas of service provision, medical education, and r...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.306.6871.199

    authors: Maxwell R

    更新日期:1993-01-16 00:00:00

  • Use of vitamin B-12 in Leicestershire practices: a single topic audit led by a medical audit advisory group.

    abstract:OBJECTIVE:To encourage active participation of Leicestershire general practitioners and their staff in audit; to examine the use of vitamin B-12 injections and to achieve a more appropriate use. DESIGN:Implementation of an agreed audit protocol, with central analysis and feedback of anonymous and aggregated data by a ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.311.6996.28

    authors: Fraser RC,Farooqi A,Sorrie R

    更新日期:1995-07-01 00:00:00

  • Integrating undergraduate and postgraduate education in general practice: experience in Tayside.

    abstract::Several forces have resulted in the creation in Tayside of the first formally integrated unit of undergraduate and postgraduate education in general practice in the United Kingdom. Forces that helped this integration included the desire for change, national developments in education, financial support through funds se...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.310.6994.1577

    authors: Bain J,Scott R,Snadden D

    更新日期:1995-06-17 00:00:00

  • Variation in rates of caesarean section among English NHS trusts after accounting for maternal and clinical risk: cross sectional study.

    abstract:OBJECTIVE:To determine whether the variation in unadjusted rates of caesarean section derived from routine data in NHS trusts in England can be explained by maternal characteristics and clinical risk factors. DESIGN:A cross sectional analysis using routinely collected hospital episode statistics was performed. A multi...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.c5065

    authors: Bragg F,Cromwell DA,Edozien LC,Gurol-Urganci I,Mahmood TA,Templeton A,van der Meulen JH

    更新日期:2010-10-06 00:00:00

  • Using care bundles to reduce in-hospital mortality: quantitative survey.

    abstract:PROBLEM:To reduce hospital inpatient mortality and thus increase public confidence in the quality of patient care in an urban acute hospital trust after adverse media coverage. DESIGN:Eight care bundles of treatments known to be effective in reducing in-hospital mortality were used in the intervention year; adjusted m...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.c1234

    authors: Robb E,Jarman B,Suntharalingam G,Higgens C,Tennant R,Elcock K

    更新日期:2010-03-31 00:00:00

  • Will new diagnostic criteria for diabetes mellitus change phenotype of patients with diabetes? Reanalysis of European epidemiological data. DECODE Study Group on behalf of the European Diabetes Epidemiology Study Group.

    abstract:OBJECTIVE:To evaluate the impact of the revised diagnostic criteria for diabetes mellitus adopted by the American Diabetes Association on prevalence of diabetes and on classification of patients. For epidemiological purposes the American criteria use a fasting plasma glucose concentration >=7.0 mmol/l in contrast with ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.317.7155.371

    authors:

    更新日期:1998-08-08 00:00:00

  • Factors associated with mortality in Scottish patients receiving methadone in primary care: retrospective cohort study.

    abstract:OBJECTIVE:To assess predictors of mortality in a population of people prescribed methadone. DESIGN:Retrospective cohort study. SETTING:Geographically defined population in Tayside, Scotland. PARTICIPANTS:2378 people prescribed and dispensed liquid methadone between January 1993 and February 2004. MAIN OUTCOME MEASU...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.b2225

    authors: McCowan C,Kidd B,Fahey T

    更新日期:2009-06-16 00:00:00

  • Change in social status and risk of low birth weight in Denmark: population based cohort study.

    abstract:OBJECTIVE:To estimate the risk of having a low birthweight infant associated with changes in social, environmental, and genetic factors. DESIGN:Population based, historical cohort study using the Danish medical birth registry and Statistic Denmark's fertility database. SUBJECTS:All women who had a low birthweight inf...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.315.7121.1498

    authors: Basso O,Olsen J,Johansen AM,Christensen K

    更新日期:1997-12-06 00:00:00

  • Effectiveness of rotavirus vaccination against childhood diarrhoea in El Salvador: case-control study.

    abstract:OBJECTIVE:To evaluate the effectiveness of a monovalent rotavirus vaccine against severe rotavirus disease and to assess its impact on diarrhoea in children aged less than 2 years after national introduction in El Salvador, a low-middle income country in Central America. DESIGN:Matched case-control study. SETTING:Sev...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.c2825

    authors: de Palma O,Cruz L,Ramos H,de Baires A,Villatoro N,Pastor D,de Oliveira LH,Kerin T,Bowen M,Gentsch J,Esposito DH,Parashar U,Tate J,Patel M

    更新日期:2010-06-15 00:00:00

  • Assessment of female sex as a risk factor in atrial fibrillation in Sweden: nationwide retrospective cohort study.

    abstract:OBJECTIVE:To determine whether women with atrial fibrillation have a higher risk of stroke than men. DESIGN:Nationwide retrospective cohort study. SETTING:Patients with a diagnosis of atrial fibrillation in the Swedish hospital discharge register between 1 July 2005 and 31 December 2008. Information about drug treatm...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.e3522

    authors: Friberg L,Benson L,Rosenqvist M,Lip GY

    更新日期:2012-05-30 00:00:00

  • Births in Great Britain resulting from assisted conception, 1978-87. MRC Working Party on Children Conceived by In Vitro Fertilisation.

    abstract:OBJECTIVE:To describe the characteristics at birth of children conceived by in vitro fertilisation (IVF) or by gamete intrafallopian transfer (GIFT) and to assess whether they differ from those of children conceived naturally. DESIGN:Survey of children resulting from IVF or GIFT and comparison of their characteristics...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.300.6734.1229

    authors:

    更新日期:1990-05-12 00:00:00