Key result
Physician-pharmacist co-management significantly lowered 24-hour systolic blood pressure compared to the control group (120.4 mm Hg vs 131.8 mm Hg; P<.001).
Why the study?
Does physician-pharmacist co-management improve 24-hour blood pressure control in patients at family medicine clinics?
RCT (n=374)
Cluster-randomized
Yes
Does physician-pharmacist co-management improve 24-hour blood pressure control in patients at family medicine clinics?
Absolute Event Rate: 120.4% vs 131.8%
p-value: p=<.001
Physician-pharmacist co-management significantly improves 24-hour ambulatory blood pressure control through greater intensification of antihypertensive therapy.
May support collaborative BP care in primary care; leaves open effects on cardiovascular outcomes.
The objectives of this study were to compare indices of 24-hour blood pressure (BP) following a physician-pharmacist collaborative intervention and to describe the associated changes in antihypertensive medications. This was a secondary analysis of a prospective, cluster-randomized clinical trial conducted in 6 family medicine clinics randomized to co-managed (n=3 clinics, 176 patients) or control (n=3 clinics, 198 patients) groups. Mean ambulatory systolic BP (SBP) was significantly lower in the co-managed vs the control group: daytime BP 122.8 mm Hg vs 134.4 mm Hg (P<.001); nighttime SBP 114.8 mm Hg vs 123.7 mm Hg (P<.001); and 24-hour SBP 120.4 mm Hg vs 131.8 mm Hg (P<.001), respectively. Significantly more drug changes were made in the co-managed than in the control group (2.7 vs 1.1 changes per patient, P<.001), and there was greater diuretic use in co-managed patients (79.6% vs 62.6%, P<.001). Ambulatory BPs were significantly lower for the patients who had a diuretic added during the first month compared with those who never had a diuretic added (P<.01). Physician-pharmacist co-management significantly improved ambulatory BP compared with the control group. Antihypertensive drug therapy was intensified much more for patients in the co-managed group.
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Chen et al. (2013) conducted an RCT in Hypertension (n=374). Physician-pharmacist co-management vs. Control was evaluated on 24-hour systolic blood pressure (p=<.001). Physician-pharmacist co-management significantly lowered 24-hour systolic blood pressure compared to the control group (120.4 mm Hg vs 131.8 mm Hg; P<.001).
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