Physician-pharmacist collaboration versus usual care for treatment-resistant hypertension.

Steven M Smith, Nicholas W Carris, Eric Dietrich, John G Gums, Liz Uribe, Christopher S Coffey, Tyler H Gums, Barry L Carter

Journal: Journal of the American Society of Hypertension : JASH 2017;10(4):307-17

PMID: 26852290

Abstract

Team-based care has been recommended for patients with treatment-resistant hypertension (TRH), but its efficacy in this setting is unknown. We compared a physician-pharmacist collaborative model (PPCM) to usual care in patients with TRH participating in the Collaboration Among Pharmacists and Physicians To Improve Outcomes Now study. At baseline, 169 patients (27% of Collaboration Among Pharmacists and Physicians To Improve Outcomes Now patients) had TRH: 111 received the PPCM intervention and 58 received usual care. Baseline characteristics were similar between treatment arms. After 9 months, adjusted mean systolic blood pressure was reduced by 7 mm Hg more with PPCM intervention than usual care (P = .036). Blood pressure control was 34.2% with PPCM versus 25.9% with usual care (adjusted odds ratio, 1.92; 95% confidence interval, 0.33-11.2). These findings suggest that team-based care in the primary care setting may be effective for TRH. Additional research is needed regarding the long-term impact of these models and to identify patients most likely to benefit from team-based interventions.

Copyright © 2016 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

Address: Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, FL, USA; Department of Community Health & Family Medicine, College of Medicine, University of Florida, Gainesville, FL, USA. Electronic address: [email protected].; Department of Pharmacotherapeutics and Clinical Research, College of Pharmacy, University of South Florida, Tampa, FL, USA; Department of Family Medicine, College of Medicine, University of South Florida, Tampa, FL, USA.; Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, FL, USA; Department of Community Health & Family Medicine, College of Medicine, University of Florida, Gainesville, FL, USA.; Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA.; Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, IA, USA; Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
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