Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
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.
Weinberger M, Murray MD, Tierney WM. Antihypertensive Drugs and Renal Protection—Reply. JAMA. 2003;289(9):1103-1106. doi:10.1001/jama.289.9.1103-a