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March 5, 2003

Antihypertensive Drugs and Renal Protection—Reply

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289(9):1103-1106. doi:10.1001/jama.289.9.1103-a

In Reply: Mr Guidry suggests that our results may have been different in independent community pharmacies. We believe that the same pressures to fill prescriptions likely exist in these settings. Although we lack evidence to refute Guidry' s contention, our study demonstrates the need for well-designed randomized trials to test his hypothesis.

Dr Jameson and Mr Plas state that pharmacists' professionalism should include the responsibility for patients' drug therapy outcomes. We wish to emphasize that many pharmacists in our study reported enthusiasm for implementing our pharmaceutical care program. However, we agree with Jameson and Plas that the incentives to do so did not exist. We disagree, however, with their contention that our randomization method (by store) was flawed. Randomization by store was necessary for both methodological (ie, avoiding contamination) and for practical reasons. As we reported, stores were matched on important potential confounders, and we controlled for baseline differences.

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