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Physician-Pharmacist Collaborative Drug Therapy Management in Pediatric Hypertension
Bryan J Donald1, Terry D King2, Brandon L Phillips2
1School of Clinical Sciences (BJD), University of Louisiana Monroe College of Pharmacy, Monroe, LA.
Insights
Physician-pharmacist collaboration in pediatric hypertension care improved blood pressure control and appointment adherence. This collaborative drug therapy management (CDTM) approach shows promise for better outcomes in children with high blood pressure.
Area of Science:
- Pediatric Cardiology
- Pharmacology
- Public Health
Background:
- Pediatric hypertension affects 2-5% of US children and adolescents, often undertreated.
- Increasing prevalence and physician shortages complicate treatment.
- Physician-pharmacist collaboration has improved adult hypertension outcomes.
Purpose of the Study:
- To evaluate the effectiveness of collaborative drug therapy management (CDTM) for pediatric hypertension.
- To assess if physician-pharmacist collaboration improves blood pressure control in children.
Main Methods:
- Retrospective study comparing CDTM (2020-2021) with traditional care (2018-2019) in a pediatric cardiology clinic.
- Primary outcomes: at-goal blood pressure at 3, 6, 12 months, and time to control.
- Secondary outcomes: appointment adherence and adverse events.
Main Results:
- 54% of CDTM patients achieved at-goal blood pressure at 12 months vs. 36% in traditional care (OR, 2.09).
- Appointment non-adherence was lower in the CDTM group (9.4% vs. 16%).
- Adverse events were similar between groups.
Conclusions:
- CDTM significantly increased rates of achieving at-goal blood pressure in pediatric patients.
- Physician-pharmacist collaboration is a viable strategy to improve pediatric hypertension management.
- CDTM offers improved outcomes without increased safety concerns.
Objective:
Pediatric hypertension affects 2% to 5% of children and adolescents in the United States and is frequently undertreated. The increasing prevalence of pediatric hypertension and worsening physician shortage create difficulties in closing this treatment gap. Physician-pharmacist collaborations have been shown to improve patient outcomes in adult patients. Our aim was to demonstrate a similar benefit for pediatric hypertension.
Methods:
Pediatric patients whose hypertension was managed at a single pediatric cardiology clinic from January 2020 to December 2021 were enrolled in collaborative drug therapy management (CDTM). Patients whose hypertension was managed in the same clinic from January 2018 to December 2019 were used as a comparison group. The primary outcomes were achievement of at-goal blood pressure at 3, 6, and 12 months and time to control of hypertension. Secondary outcomes were appointment adherence and serious adverse events.
Results:
A total of 151 patients were included in the CDTM group, and 115 patients were included in the traditional care group. Of those, 100 CDTM patients and 78 traditional care patients were assessed for the primary outcome. Fifty-four (54%) CDTM patients and 28 (36%) traditional care patients achieved at-goal blood pressure at 12 months (OR, 2.09; 95% CI, 1.14-3.85). Appointment non-adherence was 9.4% for CDTM and 16% for traditional care (OR, 0.54; 95% CI, 0.35-0.82). Adverse events were similar between groups.
Conclusions:
CDTM increased rates of at-goal blood pressure without increased adverse events. Physician-pharmacist collaboration may improve treatment of hypertension in pediatric patients.
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