A Mixed-Method Approach to Evaluate a Pharmacist Intervention for Veterans With Hypertension

Authors

  • Christopher P. Parker PharmD, BCACP,

    Corresponding author
    1. Department of Pharmacy Practice and Science, College of Pharmacy, Iowa City, IA
    • Address for correspondence: Christopher P. Parker, PharmD, Room 558, College of Pharmacy, University of Iowa, Iowa City, IA 52242

      E-mail: christopher-parker@uiowa.edu

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  • Cassie L. Cunningham MPH,

    1. Center for Comprehensive Access & Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, IA
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  • Barry L. Carter PharmD,

    1. Department of Pharmacy Practice and Science, College of Pharmacy, Iowa City, IA
    2. Center for Comprehensive Access & Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, IA
    3. Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA
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  • Mark W. Vander Weg PhD,

    1. Center for Comprehensive Access & Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, IA
    2. Department of Internal Medicine, Division of General Internal Medicine, Carver College of Medicine, Iowa City, IA
    3. Department of Psychology, University of Iowa, Iowa City, IA
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  • Kelly K. Richardson PhD,

    1. Center for Comprehensive Access & Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, IA
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  • Gary E. Rosenthal MD

    1. Center for Comprehensive Access & Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, IA
    2. Department of Internal Medicine, Division of General Internal Medicine, Carver College of Medicine, Iowa City, IA
    3. University of Iowa Institute for Clinical and Translational Science, Iowa City, IA
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Abstract

This paper examines blood pressure (BP) control after 6 months of an intensive pharmacist-managed intervention in a mixed-methods randomized controlled trial conducted at the Iowa City Veteran Affairs Health Care System and two community-based outreach clinics. Patients received the pharmacist intervention for the first 6 months. The study coordinator conducted a summative evaluation with 37 patients 18 to 24 months following the initial 6-month intervention period. BP was significantly reduced in diabetic patients following an intensive pharmacist intervention (−8.0/−4.0±14.4/9.1 mm Hg systolic/diastolic, P<.001 and P=.001, respectively). BP was reduced even more in nondiabetic patients (−14.0/−5.0±1.9/10.0 mm Hg, P<.001). Medication adherence significantly improved from baseline to 6 months (P=.017). BPs were significantly lower at 6 months following an intensive pharmacist intervention. Patients also expressed a high level of satisfaction with and preference for co-management of their hypertension, as well as other chronic diseases.

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