A cluster randomized trial to evaluate physician/pharmacist collaboration to improve blood pressure control

J Clin Hypertens (Greenwich). 2008 Apr;10(4):260-71. doi: 10.1111/j.1751-7176.2008.07434.x.

Abstract

This was a prospective, cluster randomized controlled trial in patients with uncontrolled hypertension aged 21 to 85 years (mean, 61 years). Pharmacists made recommendations to physicians for patients in the intervention clinics (n=101) but not patients in the control clinics (n=78). The mean adjusted difference in systolic blood pressure (BP) between the control and intervention groups was 8.7 mm Hg (95% confidence interval [CI], 4.4-12.9), while the difference in diastolic BP was 5.4 mm Hg (CI, 2.8-8.0) at 9 months. The 24-hour BP levels showed similar effects, with a mean systolic BP level that was 8.8 mm Hg lower (CI, 5.0-12.6) and a mean diastolic BP level that was 4.6 mm Hg (CI, 2.4-6.8) lower in the intervention group. BP was controlled in 89.1% of patients in the intervention group and 52.9% in the control group (adjusted odds ratio, 8.9; CI, 3.8-20.7; P<.001). Physician/pharmacist collaboration achieved significantly better mean BP values and overall BP control rates, primarily by intensification of medication therapy and improving patient adherence.

Trial registration: ClinicalTrials.gov NCT00201045.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Pressure
  • Cluster Analysis
  • Cooperative Behavior
  • Educational Measurement
  • Female
  • Humans
  • Hypertension / prevention & control*
  • Interprofessional Relations*
  • Male
  • Middle Aged
  • Patient Care Team*
  • Pharmacists*
  • Physicians*
  • Prospective Studies
  • Systole

Associated data

  • ClinicalTrials.gov/NCT00201045