Comparative Effectiveness Research: Evaluating Pharmacist Interventions and Strategies to Improve Medication Adherence

It is commonly thought that poor BP control is caused by poor patient adherence, poor guideline adherence by physicians, and limited access to care. 2] here are many reasons why physicians might fail to achieve BP control including patient's resistance to adding or adjusting medications, concern about the predictive value or accuracy of office BP measurements, patient-reported home BP measurements, suspected white-coat hypertension, more urgent competing medical problems, BP already close to goal, or the patient experiencing stress on the day of the clinic visit. However, exclusively blaming physicians or patients for this public health problem is somewhat misguided. 6] In reality, concepts of the Medical Home have been articulated for at least 40 years and involve an ongoing relationship with a personal physician who leads the medical team to improve the quality of care. The Patient-Centered Medical Home is structured such that the point of access to care is organized around the needs of the patient, built upon the relationship with the patient, and their personal physician where a team may form and reform according to the needs of the patient. The physician may delegate responsibility to the pharmacist to perform a medication history, identify problems and barriers to achieving disease control, and to adjust medications following guidelines. Frequent communication of goal-directed therapy allows the physician to address more acute problems and complications.