Pharmacists' ability to influence outcomes of hypertension therapy

We measured the impact of pharmaceutical care on outcomes of antihypertensive therapy for patients with elevated baseline blood pressures who were attending an urban university-affiliated internal medicine clinic. The intervention group received education about hypertension, drug and nondrug management, and assistance to enhance compliance. The pharmacist made recommendations to physicians regarding pharmacotherapy. The control group received no such education, and interventions relating to pharmacotherapy were only physician initiated. Over an average follow-up of 5 months, significant-decreases in mean blood pressures were noted for the intervention group from baseline to final assessment (156.5/144.5 mm Hg systolic, p = 0.001; 91.6/86.9 mm Hg diastolic, p = 0.01), with insignificant changes in mean pressures in the control group (153.7/151.0 mm Hg systolic, p = 0.48; 90.4/87.8 mm Hg diastolic, p = 0.29). Comparing the groups, the change in diastolic pressures was insignificant (4.7 vs 2.6 mm Hg intervention vs control, p = 0.49), but the change in systolic pressure was more impressive (12.0 vs 2.7 mm Hg, respectively, p = 0.05). There was no significant difference in SF-36 Health Survey scores between groups. A significant decrease (p = 0.03) in the SF-36 physical functioning domain was seen in the intervention group, but no other significant changes in health-related quality of life scores. Pharmaceutical care contributed to improved blood pressure control in these patients.