Patients under pharmacist care have better BP control

When it comes to patients with uncontrolled hypertension, those working with teams that include a pharmacist have better blood pressure control than those only working with doctors, according to research by the University of Iowa (UI).

The UI findings were presented on May 18 at the American Society of Hypertension’s annual conference in New York. The findings were from two studies by research teams led by UI Pharmacy Professor Barry Carter, PharmD, and were first published online March 24 in Circulation: Cardiovascular Quality and Outcomes.

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Starting in 2010 and ending in 2013, researchers analyzed patient outcomes at 32 medical offices in 15 states. They found that blood pressure control at nine months was best for patients monitored by physician-pharmacist teams, with sustained improvement through 24 months for minorities.

Patients (n=625) were divided into three statistical groups: those receiving brief and sustained intervention that included follow-up from pharmacists for nine months; those receiving follow-up from pharmacists for 24 months; and those only receiving periodic follow-up with physicians.

Researchers measured patients' blood pressure control, the level of care each received, and their medication adherence.

They found that a higher percentage of patients who received follow-up involving pharmacists had controlled blood pressure (43% versus 34%), although this did not reach statistical significance.

"That means, if you saw a care team with a clinical pharmacist, your blood pressure was more likely to be lower," said Tyler Gums, a postdoctoral researcher in the UI College of Pharmacy.

Minority patients do better

The results were even more dramatic for minority patients. At 24 months, minority patients in the 9-month follow-up pharmacist groups had an 8.2% reduction in mean blood pressure, while those in the 24-month follow-up groups had a 9.2% mm Hg reduction in mean blood pressure. Nonminority patients in the pharmacist groups had a lower mean blood pressure reduction at 24 months of 4.9% in the nine-month follow-up group and 7.9% mm Hg in the 24-month follow-up group.

“These findings suggest that an established team-based care model involving pharmacists can be adopted in a large number of offices to reduce racial disparities in [blood pressure] control,” Carter wrote.