Key result
Pharmacist management is linked to a ~11 mm Hg SBP reduction compared to physician/nurse management.
Why the study?
Pharmacists’ management of blood pressure may assist with reducing systolic blood pressure and improving hypertension control in ambulatory care settings.
Does pharmacist management of hypertension improve systolic blood pressure reduction and goal attainment compared to physician/nurse management in ambulatory care patients?
Observational (n=47)
No
Does pharmacist management of hypertension improve systolic blood pressure reduction and goal attainment compared to physician/nurse management in ambulatory care patients?
Pharmacist-led hypertension management in an ambulatory care clinic significantly improves systolic blood pressure reduction and goal attainment compared to standard physician/nurse care.
Answers are grounded in this paper and cite their sources.
May support pharmacist integration in hypertension care; hypothesis-generating and requires randomized confirmation before practice change.
Background: A reduction of 10 mm Hg in systolic blood pressure (SBP) significantly decreases the risk of major cardiovascular disease events. Pharmacists’ management of blood pressure may assist with this reduction. Objective: Assess the impact of pharmacist management of hypertension via a collaborative practice agreement with physicians in an ambulatory care clinic. Methods: The first phase of this study was a retrospective chart review of physician/nurse hypertension visits from October 2019 to August 2020. The second prospective phase consisted of pharmacist managed hypertension visits from December 2020 to January 2021. The primary outcome was the change in SBP from the beginning to the end of the study period in the prospective group. Secondary outcomes included the proportion of patients achieving their blood pressure goal and the proportion of patients adherent to all antihypertensive medications at their follow-up visits in both groups. This study was institutional review board approved. Results: Forty-seven patients were included and analyzed (24 in the retrospective group and 23 in the prospective group). Patients in the prospective group had an average SBP lowering of 10.83 mm Hg ( P = .0035). Thirteen patients (56.5%) met their blood pressure goal of <130/80 mm Hg in the prospective group, compared to 5 patients (20.8%) in the retrospective group ( P = .012). One adverse event occurred during this study. Limitations included small sample size and short duration of study. Conclusion: Patients had an average SBP lowering of >10 mm Hg. More patients reached a goal blood pressure of <130/80 mm Hg when managed by pharmacists.
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Chonko et al. (2021) conducted an observational in Hypertension (n=47). Pharmacist management of hypertension vs. Physician/nurse management was evaluated on change in SBP from the beginning to the end of the study period in the prospective group (p=.0035). Pharmacist management of hypertension resulted in an average systolic blood pressure lowering of 10.83 mm Hg (P=0.0035) and higher goal achievement than physician/nurse management (56.5% vs 20.8%).
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