Physician-Pharmacist Co-Management and 24-Hour Blood Pressure Control
Article first published online: 12 FEB 2013
© 2013 Wiley Periodicals, Inc.
The Journal of Clinical Hypertension
Volume 15, Issue 5, pages 337–343, May 2013
How to Cite
J Clin Hypertens (Greenwich). 2013;15:337–343. ©2013 Wiley Periodicals, Inc.
- Issue published online: 24 APR 2013
- Article first published online: 12 FEB 2013
- Manuscript Accepted: 2 JAN 2013
- Manuscript Revised: 27 DEC 2012
- Manuscript Received: 30 OCT 2012
- National Heart, Lung, and Blood Institute. Grant Numbers: HL069801, HL070740
- Agency for Healthcare Research and Quality (AHRQ). Grant Number: #5U18HSO16094
- Comprehensive Access and Delivery Research and Evaluation (CADRE)
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.