May 23, 2012

Blood Pressure Dropped When Pharmacists Gave Patients a Ring

Atlanta, GAWithin just 6 months, nearly 72% of patients receiving regular telemonitoring intervention with pharmacists reduced their uncontrolled high blood pressure (BP) to healthy levels under 140/90 mm Hg (or under 130/80 Hg in those with kidney disease or diabetes). That's compared to just about 45% in the traditional care group who only visited their physicians a few times a year, according to a study presented at the recent American Heart Association's Quality of Care and Outcomes Research Scientific Sessions 2012 in Atlanta.

Not only was blood pressure more likely to decrease with the pharmacist intervention, but its relative decrease was greater in the group getting telephone calls. When the study began, the average of the overall study group's blood pressure was 148/85 mm Hg. After 6 months, the average had dropped to 126/76 mm Hg in the telemonitoring intervention group and 138/82 mm Hg in the traditional care group.

"Patients with high blood pressure visit physicians an average of four times each year, yet blood pressure is controlled in only about half of U.S. patients," said Karen Margolis, MD, MPH, the study's lead author and director of clinical research of HealthPartners Research Foundation in Bloomington, MN. "We looked at how the addition of a pharmacist-led, at-home telemonitoring program might improve patients' blood pressure control."

Margolis and her coauthors said they decided to test the pharmacist-intervention concept because "practical, robust and sustainable models are needed to improve BP in patients with uncontrolled hypertension."

About half of the 450 patients in the study group (222) were assigned to traditional care through their primary care providers, while the other half (228) saw their primary care providers but received additional high blood pressure management and telemonitoring support from a pharmacist. Those patients tested their blood pressure at home and uploaded the results to a secure Web site where pharmacists were able to monitor them. The pharmacists, who were able to adjust antihypertensive therapy based on the home BP data under a collaborative practice agreement with teams at eight primary care clinics, contacted the patients every 2 to 4 weeks by telephone.

The intervention is scheduled to last 12 months, with follow up 6 months later to gauge the longer-term value of the intervention.

"These early results suggest that home blood pressure telemonitoring with extra telephone care by a pharmacist was very effective in improving blood pressure control," Margolis said. "If these early results can be sustained over the long run, it might decrease the number of patients who suffer heart attacks, strokes or other complications of high blood pressure."

Margolis cautioned that these study participants were health-conscious, so results could be different for a less motivated group.

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