Real-World Effectiveness in Hypertension and Hyperlipidemia Collaborative Management between Pharmacies and Primary Care in Portugal: A Multicenter Pragmatic Controlled Trial (USFarmácia ® )

Suzete Costa (), José Luís Biscaia, Maria Rute Horta, Sónia Romano, José Guerreiro, Peter Heudtlass, Maria Cary, Mariana Romão, António Teixeira Rodrigues, Ana Miranda, Ana Paula Martins, Ana Sofia Bento, João Pereira, Ceu Mateus and Dennis K. Helling
Additional contact information
Suzete Costa: NOVA National School of Public Health (ENSP), Universidade NOVA de Lisboa, 1600-560 Lisboa, Portugal
José Luís Biscaia: USF São Julião da Figueira, Agrupamento dos Centros de Saúde (ACeS) do Baixo Mondego, 3080-134 Figueira da Foz, Portugal
Maria Rute Horta: Centre for Medicines Information and Health Interventions (CEDIME), Infosaúde, Associação Nacional das Farmácias, 1249-069 Lisboa, Portugal
Sónia Romano: Centre for Health Evaluation & Research (CEFAR), Infosaúde, Associação Nacional das Farmácias, 1249-069 Lisboa, Portugal
José Guerreiro: Centre for Health Evaluation & Research (CEFAR), Infosaúde, Associação Nacional das Farmácias, 1249-069 Lisboa, Portugal
Peter Heudtlass: Centre for Health Evaluation & Research (CEFAR), Infosaúde, Associação Nacional das Farmácias, 1249-069 Lisboa, Portugal
Maria Cary: Centre for Health Evaluation & Research (CEFAR), Infosaúde, Associação Nacional das Farmácias, 1249-069 Lisboa, Portugal
Mariana Romão: Centre for Health Evaluation & Research (CEFAR), Infosaúde, Associação Nacional das Farmácias, 1249-069 Lisboa, Portugal
António Teixeira Rodrigues: Centre for Health Evaluation & Research (CEFAR), Infosaúde, Associação Nacional das Farmácias, 1249-069 Lisboa, Portugal
Ana Miranda: Registo Oncológico Nacional, Instituto Português de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisboa, Portugal
Ana Paula Martins: Institute for Evidence-Based Health (ISBE), 1649-028 Lisboa, Portugal
Ana Sofia Bento: USF São Julião da Figueira, Agrupamento dos Centros de Saúde (ACeS) do Baixo Mondego, 3080-134 Figueira da Foz, Portugal
João Pereira: NOVA National School of Public Health (ENSP), Universidade NOVA de Lisboa, 1600-560 Lisboa, Portugal
Dennis K. Helling: Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Denver, CO 80045, USA

IJERPH, 2023, vol. 20, issue 15, 1-25

Abstract: There is evidence of the efficacy of collaborative health interventions with pharmacies and primary care providers but little of its real-world effectiveness. We aimed to assess the effectiveness and discuss the design and challenges of hypertension and hyperlipidemia management between pharmacies and primary care providers using real-world data exchange between providers and experimental bundled payment. This was a pragmatic, quasi-experimental controlled trial. We collected patient-level data from primary care prescription claims and Electronic Medical Record databases, a pharmacy claims database, and patient telephone surveys at several time points. The primary outcomes were changes in blood pressure and total cholesterol. We used matched controls with difference-in-differences estimators in a Generalized Linear Model (GLM) and controlled interrupted time series (CITS). We collected additional data for economic and qualitative studies. A total of 6 Primary Care Units, 20 pharmacies, and 203 patients entered the study. We were not able to observe significant differences in the effect of intervention vs. control. We experienced challenges that required creative strategies. This real-world trial was not able to show effectiveness, likely due to limitations in the primary care technology which affected the sample size. It offers, however, valuable lessons on methods, strategies, and data sources, paving the way for more real-world effectiveness trials to advance value-based healthcare.

Keywords: community pharmacy; primary care; pharmacy services; collaborative; hypertension; hyperlipidemia; trial; effectiveness; real-world; public health interventions (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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