Deterioration of Blood Pressure Control After Discontinuation of a Physician-Pharmacist Collaborative Intervention

• Published in: Pharmacotherapy 2010-03, Vol.30 (3), p.228-235
• Main Authors: Carter, Barry L., Doucette, William R., Franciscus, Carrie L., Ardery, Gail, Kluesner, Karen M., Chrischilles, Elizabeth A.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antihypertensive Agents - administration & dosage; Antihypertensive Agents - therapeutic use; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure - drug effects; blood pressure control; Cardiology. Vascular system; clinical trial; Female; Follow-Up Studies; Humans; Hypertension - prevention & control; hypertension management; Interprofessional Relations; Male; Medical Records; Medical sciences; Medication Adherence; Middle Aged; Pharmaceutical Services; pharmacist management; Pharmacists; Pharmacology. Drug treatments; Physicians; Practice Guidelines as Topic; team care; United States; Young Adult
• ISSN: 0277-0008; 1875-9114
• DOI: 10.1592/phco.30.3.228

Study Objective. To assess blood pressure control after discontinuation of a physician‐pharmacist collaborative intervention. Design. Comparative analysis of data of the patients who received the intervention versus a control group from a prospective, cluster‐randomized, 9‐ month efficacy trial and the same patients' data 18 and 27 months after completion of the trial, ed from their medical records. Setting. Five primary care medical offices operated by a university health system. Patients. One hundred four patients with hypertension; 65 were in the intervention group, and 39 were in the control group. Measurements and Main Results. In the prospective study, patients were randomized to receive a physician‐pharmacist collaborative intervention to improve blood pressure control or to the control group. Systolic and diastolic blood pressures were measured by a research nurse at baseline and at the end of the study (9 mo later). In the current study, data were ed for blood pressure and blood pressure control at 18 and 27 months (9 and 18 mo, respectively, after discontinuation of the study). At baseline, mean ± SD systolic blood pressure was 152.5 ± 9.5 and 150.1 ± 9.6 mm Hg in the intervention and control groups, respectively (p=0.22). At 9 months, systolic blood pressure decreased to 124.5 ± 10.7 and 132.0 ± 15.1 mm Hg (p=0.0038 between groups), and blood pressure was controlled in 78.5% and 48.7% (p=0.0017) of patients in the intervention and control groups, respectively: By 18 months, systolic blood pressure had deteriorated to 131.0 ± 12.2 and 143.3 ± 17.5 mm Hg (p