Key result
Pharmacist collaborative care with supplementary prescribing authority lowers systolic BP ~18 mmHg vs. medical centered care.
Why the study?
Clinical outcomes of pharmacist supplementary prescribing for reducing blood pressure compared with other care models in recently diagnosed hypertensive patients had not been evaluated.
Does pharmacist collaborative care with supplementary prescribing authority improve blood pressure reduction in patients with recently diagnosed hypertension?
RCT (n=225)
Does pharmacist collaborative care with supplementary prescribing authority improve blood pressure reduction in patients with recently diagnosed hypertension?
Mean Difference: -17.8 (95% CI -19.8–-13.8)
p-value: p=<0.001
Pharmacist collaborative care with supplementary prescribing authority significantly improves blood pressure and cholesterol management in newly diagnosed hypertensive patients compared to standard medical care or pharmacist care without prescribing authority.
May support pharmacist prescribing authority in hypertension; hypothesis-generating and requires randomized trials before practice change.
To evaluate the clinical outcomes of supplementary prescribing by pharmacist in reducing blood pressure versus other models of care in patients who recently received medical diagnosis of hypertension. A 24-month pragmatic controlled trial was performed with 225 patients divided into three groups: control 1 (medical centered care), control 2 (pharmacist collaborative care without supplementary prescribing authority) and intervention (pharmacist collaborative care with supplementary prescribing authority). A comparison of values was performed at basal and after 24-months of follow up in each group and differences between groups. We applied the chi-square test, student's t-test for independent samples, one-way anova whenever appropriate. A p value < 0.05 was considered statistically significant. Significant reduction in sbp and dbp was verified in every groups; intervention group showed a significantly higher reduction in the mean blood pressure levels versus control 2 (δ vs. Control 2 group = -14.3 [ci95 % -12.6 to -15.9 mmhg] p = 0.006; δ vs. Control 1 group = -17.8 [ci95 % -13.8 to -19.8 mmhg] p < 0.001) and dbp (δ vs. Control 2 group = -8.9 [ci95 % -7.7 to -10.9 mmhg] p = 0.005; δ vs. Control 1 group = -9.8 [ci95 % -7.7 to -11.5 mmhg] p < 0.001). Intervention group also showed significantly higher reduction in ldl-cholesterol and total cholesterol, versus other groups. Pharmacist collaborative care with supplementary prescribing authority provided better results in the management of blood pressure, ldl-cholesterol and total cholesterol versus other models of care.
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Obreli-Neto et al. (2025) conducted an RCT in Hypertension (n=225). Pharmacist collaborative care with supplementary prescribing authority vs. Medical centered care and pharmacist collaborative care without supplementary prescribing authority was evaluated on Reduction in systolic blood pressure (MD -17.8, 95% CI -19.8 to -13.8, p=<0.001). Pharmacist collaborative care with supplementary prescribing authority significantly reduced systolic blood pressure compared to medical centered care (MD -17.8 mmHg; 95% CI -19.8 to -13.8; p<0.001).
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