Canadian Pharmacists Journal / Revue des Pharmaciens du Canada

Pharmacist-led interventions have demonstrated benefits across various medical conditions; however, their impact on atrial fibrillation (AF) remains unexplored. This study aims to synthesize the available evidence regarding the pharmacist’s role in AF management.

A systematic review with searches in PubMed, Scopus, and Web of Science was performed (PROSPERO: CRD42025647848). Randomized and non-randomized trials, as well as cohort studies reporting clinical, process, and humanistic outcomes, were included. Findings were pooled through pairwise meta-analyses. Dichotomous outcomes were reported as risk ratios (RRs) and continuous variables as standardized mean differences (SMDs) with 95% confidence intervals (CIs). The quality of the randomized and non-randomized studies was assessed using RoB 2.0 and ROBINS-I tools, respectively. Evidence was graded using the GRADE approach.

Seventeen studies (n = 11,428 participants) published between 2008 and 2024, predominantly as non-randomized trials/cohorts (77%), were included. Pharmacist-led interventions varied widely in scope, including anticoagulation management services, medication therapy management, and prescribing. Meta-analyses showed that pharmacists improved time in therapeutic range (SMD 0.35; 95% CI, 0.13–0.56) and reduced major bleeding events (RR 0.76; 95% CI, 0.61–0.95) and strokes (RR 0.65; 95% CI, 0.44–0.94) compared with usual care. Pharmacist care also increased appropriate prescription rates (RR 1.36, 95% CI, 1.18–1.56). No significant differences were found for other outcomes. Evidence was of low-to-moderate certainty.

Pharmacist-led interventions have been shown to improve certain clinical and process outcomes in AF.

High-quality randomized studies with well-defined interventions are still needed to better refine the pharmacist’s role in AF care and to identify the most effective intervention in practice (see Graphical Abstract). Can Pharm J (Ott) 2025;158:xx-xx.

The University of British Columbia Faculty of Pharmaceutical Sciences led the 3-year implementation of the Pharmacists in Primary Care Network (PCN) Program in collaboration with regional health authorities and PCNs across British Columbia (BC). Primary care clinical pharmacists (PCCPs) were integrated into 47 PCNs from October 1, 2020 to September 30, 2023. Our study aimed to describe the experiences of patients after receiving care from a PCCP as a member of the interprofessional team in PCNs.

This study was conducted as part of the program evaluation and was informed by qualitative description methodology to produce themes. Patients who had 2 or more appointments with a PCCP were randomly selected to participate, with representation stratified by health authority and PCN location.

We interviewed 39 patients who participated in 6 focus groups across 5 BC health authorities. Patients perceived positive changes in health management since working with PCCPs owing to their PCCP’s support with comprehensive medication reviews, patient education, and empowerment. Patients also appreciated their PCCP’s patient-centred approach, specialized knowledge, professionalism, and flexibility. Patients felt there was insufficient public awareness about the program and the PCCP role. Some patients also criticized having the family physician or nurse practitioner as the sole access point to the PCCP.

Patients’ experiences were overall positive after receiving care from a PCCP. Patients recommended promoting the program directly through social media, posters, newsletters, and billboards. In addition, self-referral and referrals from any health care provider within the PCN to PCCPs would enhance accessibility and optimize service uptake. Can Pharm J (Ott) 2025;158:xx-xx.