Sci Rep. 2026 May 27. doi: 10.1038/s41598-026-54614-w. Online ahead of print.
ABSTRACT
Hypertension is a chronic condition frequently requiring long-term pharmacotherapy, which may increase the risk of medication-related problems. Comprehensive Medication Management (CMM) has been associated with improvements in health outcomes in patients with hypertension; however, evidence from pragmatic randomized clinical trials in primary care settings remains limited. This study aimed to evaluate the association between pharmacist-led CMM on clinical, anthropometric, humanistic, and cardiovascular risk outcomes among patients with hypertension treated within the public health care network of Alegre, Espírito Santo, Brazil. A pragmatic, single-blind, randomized controlled clinical trial with a 12-month follow-up was conducted. A total of 128 adults with hypertension were randomized in a 1:1 ratio to the intervention group (CMM) or the control group (usual care). No statistically significant between-group differences were observed for clinical, anthropometric, or humanistic parameters; cardiovascular risk was the only outcome showing a statistically significant time × group interaction (p = 0.039; η2p = 0.026), indicating a trend toward a more favorable trajectory in the CMM group. Intention-to-treat analyses showed significant time effects for systolic blood pressure, lipid profile components, quality of life, hypertension-related knowledge, and cardiovascular risk in both groups. In exploratory intragroup analyses, the intervention group showed significant changes in systolic blood pressure (- 9.47 mmHg), total cholesterol, LDL cholesterol, non-HDL cholesterol, and cardiovascular risk, along with improvements in quality of life and hypertension-related knowledge, whereas the control group showed improvements limited to knowledge scores and self-rated quality of life. Per-protocol sensitivity analyses confirmed the consistency of these findings. Although between-group comparisons did not demonstrate clear statistical superiority of CMM over usual care for most outcomes, the results suggest that CMM may contribute to clinically relevant improvements in cardiovascular risk and patient-centered outcomes in real-world practice. These findings should be considered hypothesis-generating, and larger, adequately powered, multicenter pragmatic trials are warranted to confirm the effectiveness of CMM in hypertension management.
PMID:42204303 | DOI:10.1038/s41598-026-54614-w
