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Published on: December 5, 2020
Telehealth intervention by pharmacists collaboratively enhances hypertension management and outcomes
Daniel Wolverton1, Debbie Liang2, Liang Zhao2
1Managed Pharmacy Solutions, UNC Health Care System, 1025 Think Place, Ste 460, Mailbox 9, Morrisville, NC 27560.
Objective:
To evaluate the impact of a centralized pharmacist-led telehealth model utilizing home blood pressure monitoring (HBPM) readings on hypertension quality measure pass rates and blood pressure reduction at 3 and 6 months.
Study Design:
Retrospective observational cohort study.
Methods:
Adults with uncontrolled hypertension (≥ 140/90 mm Hg) were identified through a centralized outreach model. Patients who completed a visit with a pharmacist comprised the intervention group; those who were not reached or who declined were included in the usual care group. Pharmacists met with patients via telehealth appointments and sent recommendations to their providers.
Results:
A total of 1776 patients were included: 179 patients in the intervention group and 1597 patients in usual care. The mean age was 56 years (95% CI, 55.7-57.0 years), with approximately half identifying as female (47.6%-53.1%). The intervention group had a higher proportion of Black patients (53.1% vs 37.3%; P = .0002) and a higher mean Elixhauser Comorbidity Index score (2.93 vs 2.54; P = .0016). Patients in the pharmacist intervention group were more likely to pass the Healthcare Effectiveness Data and Information Set Controlling Blood Pressure measure (2022: OR, 1.78; P = .014; 2023: OR, 1.75; P = .014). Greater systolic blood pressure reductions in the intervention group vs usual care were observed at both 3 months (-12.69 vs -5.69 mm Hg; P < .0001) and 6 months (-13.87 vs -9.05 mm Hg; P = .001).
Conclusions:
Participating in telehealth visits integrating HBPM readings with a pharmacist between primary care visits significantly improves blood pressure control. Pharmacists play a critical role in actively engaging patients and optimizing medication therapy in team-based care for chronic hypertension management.
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