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November 11, 2015
Pharmacists in Medical Practices Help Increase
Hypertension Control Iowa City, IA—Less than $25 is a small price to pay for increasing the hypertension control rate by 1.0%, according to a new report about a pharmacist-physician collaborative effort. As part of the intervention for an ethnically and economically diverse group of 625 patients, clinical pharmacists in 32 medical offices reviewed patients' medical records, contacting them by phone and meeting them in regular face-to-face visits. Care plans created by pharmacists were submitted to physicians to adjust medications. Results of the study were published recently by the journal Hypertension. “Previous studies have demonstrated the cost-effectiveness of collaborative hypertension control programs. However, most lacked minority and low-income populations,” said lead researcher Linnea Polgreen, PhD, an assistant professor in the Department of Pharmacy Practice and Science at the University of Iowa. Costs were assigned to medications as well as to pharmacist and physician time, then calculated based on changes in blood pressure measurements and hypertension control rates. That was how researchers determined it cost just $22 to increase control by 1.0%. Participants in 15 states were randomized either to a pharmacist-physician intervention program for 9 months or to a control group receiving usual care. All had uncontrolled high blood pressure, defined as systolic pressure of 140 mm Hg or higher, or diastolic of 90 mm Hg or higher; for those with diabetes or chronic kidney disease, blood pressure was considered high at or above 130 mm Hg systolic or 80 mm Hg diastolic. After 9 months of the collaborative intervention, average systolic blood pressure was 6.1 mm Hg lower, average diastolic pressure was 2.9 mm Hg lower, and the hypertension control rate was 43%, compared to 34% in the control group. “Patients in the intervention groups had higher costs than those in the control group, but these costs were mostly due to higher prescription drug costs - not the cost of the pharmacist's time,” Polgreen said. “On average the pharmacist spent about two hours per patient over the course of the study.” As an added benefit, she said in an American Heart Association press release, “the intervention group had fewer physician visits, thus saving physician time for other, more complex patient health problems.”
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