Pharmacist intervention for blood pressure control: medication intensification and adherence

Area of Science:

• Clinical Pharmacy
• Cardiology
• Primary Care Medicine

Background:

• Medication adherence and intensification are crucial for managing hypertension.
• Physician-pharmacist collaborative management (PPCM) models aim to optimize patient care.
• Evaluating PPCM's impact on adherence and intensification is essential.

Purpose of the Study:

• To compare medication adherence and intensification in a PPCM model versus usual care.
• To assess the effect of PPCM on antihypertensive medication changes.
• To identify areas for improvement in PPCM strategies.

Main Methods:

• Prospective, cluster, randomized study across 32 primary care offices in 15 states.
• Intervention group received PPCM, control group received usual care.
• Primary outcomes measured at 9 months included medication adherence and antihypertensive medication changes.

Main Results:

• No significant difference in medication adherence between PPCM and usual care at 9 months.
• PPCM patients had significantly more medication changes (4.9 vs. 1.1).
• Increased use of diuretics and aldosterone antagonists observed in the PPCM group.

Conclusions:

• The PPCM model effectively increased medication intensification for hypertension.
• PPCM did not significantly improve medication adherence in this study.
• PPCM models require enhanced methods for identifying and intervening in non-adherence to maximize effectiveness.