{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T07:42:23Z","timestamp":1769586143274,"version":"3.49.0"},"reference-count":71,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:00:00Z","timestamp":1690848000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the Agrupamento dos Centros de Sa\u00fade (ACeS) (NHS Group of Primary Care Units) of the Baixo Mondego Region"},{"name":"the Associa\u00e7\u00e3o Nacional das Farm\u00e1cias (ANF) (Portuguese National Association of Pharmacies)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3390\/ijerph20156496","type":"journal-article","created":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T09:24:24Z","timestamp":1690881864000},"page":"6496","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Real-World Effectiveness in Hypertension and Hyperlipidemia Collaborative Management between Pharmacies and Primary Care in Portugal: A Multicenter Pragmatic Controlled Trial (USFarm\u00e1cia\u00ae)"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4521-5473","authenticated-orcid":false,"given":"Suzete","family":"Costa","sequence":"first","affiliation":[{"name":"NOVA National School of Public Health (ENSP), Universidade NOVA de Lisboa, 1600-560 Lisboa, Portugal"},{"name":"Institute for Evidence-Based Health (ISBE), 1649-028 Lisboa, Portugal"},{"name":"Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal"}]},{"given":"Jos\u00e9 Lu\u00eds","family":"Biscaia","sequence":"additional","affiliation":[{"name":"USF S\u00e3o Juli\u00e3o da Figueira, Agrupamento dos Centros de Sa\u00fade (ACeS) do Baixo Mondego, 3080-134 Figueira da Foz, Portugal"}]},{"given":"Maria Rute","family":"Horta","sequence":"additional","affiliation":[{"name":"Centre for Medicines Information and Health Interventions (CEDIME), Infosa\u00fade, Associa\u00e7\u00e3o Nacional das Farm\u00e1cias, 1249-069 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2055-0996","authenticated-orcid":false,"given":"S\u00f3nia","family":"Romano","sequence":"additional","affiliation":[{"name":"Centre for Health Evaluation & Research (CEFAR), Infosa\u00fade, Associa\u00e7\u00e3o Nacional das Farm\u00e1cias, 1249-069 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0690-4484","authenticated-orcid":false,"given":"Jos\u00e9","family":"Guerreiro","sequence":"additional","affiliation":[{"name":"Centre for Health Evaluation & Research (CEFAR), Infosa\u00fade, Associa\u00e7\u00e3o Nacional das Farm\u00e1cias, 1249-069 Lisboa, Portugal"}]},{"given":"Peter","family":"Heudtlass","sequence":"additional","affiliation":[{"name":"Centre for Health Evaluation & Research (CEFAR), Infosa\u00fade, Associa\u00e7\u00e3o Nacional das Farm\u00e1cias, 1249-069 Lisboa, Portugal"}]},{"given":"Maria","family":"Cary","sequence":"additional","affiliation":[{"name":"Centre for Health Evaluation & Research (CEFAR), Infosa\u00fade, Associa\u00e7\u00e3o Nacional das Farm\u00e1cias, 1249-069 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6437-0631","authenticated-orcid":false,"given":"Mariana","family":"Rom\u00e3o","sequence":"additional","affiliation":[{"name":"Centre for Health Evaluation & Research (CEFAR), Infosa\u00fade, Associa\u00e7\u00e3o Nacional das Farm\u00e1cias, 1249-069 Lisboa, Portugal"}]},{"given":"Ant\u00f3nio","family":"Teixeira Rodrigues","sequence":"additional","affiliation":[{"name":"Centre for Health Evaluation & Research (CEFAR), Infosa\u00fade, Associa\u00e7\u00e3o Nacional das Farm\u00e1cias, 1249-069 Lisboa, Portugal"}]},{"given":"Ana","family":"Miranda","sequence":"additional","affiliation":[{"name":"Registo Oncol\u00f3gico Nacional, Instituto Portugu\u00eas de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisboa, Portugal"}]},{"given":"Ana Paula","family":"Martins","sequence":"additional","affiliation":[{"name":"Institute for Evidence-Based Health (ISBE), 1649-028 Lisboa, Portugal"},{"name":"Pharmacy, Pharmacology & Health Technologies, Faculdade de Farm\u00e1cia, Universidade de Lisboa, 1649-003 Lisboa, Portugal"}]},{"given":"Ana Sofia","family":"Bento","sequence":"additional","affiliation":[{"name":"USF S\u00e3o Juli\u00e3o da Figueira, Agrupamento dos Centros de Sa\u00fade (ACeS) do Baixo Mondego, 3080-134 Figueira da Foz, Portugal"}]},{"given":"Jo\u00e3o","family":"Pereira","sequence":"additional","affiliation":[{"name":"NOVA National School of Public Health (ENSP), Universidade NOVA de Lisboa, 1600-560 Lisboa, Portugal"},{"name":"Public Health Research Centre (PHRC\/CISP), Comprehensive Health Research Centre (CHRC), 1600-560 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6219-219X","authenticated-orcid":false,"given":"C\u00e9u","family":"Mateus","sequence":"additional","affiliation":[{"name":"Health Economics at Lancaster, Division of Health Research, Lancaster University, Lancaster LA1 4YX, UK"}]},{"given":"Dennis K.","family":"Helling","sequence":"additional","affiliation":[{"name":"Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Denver, CO 80045, USA"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,1]]},"reference":[{"key":"ref_1","first-page":"47","article-title":"A 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