An evaluation of a clinical pharmacy-directed intervention on blood pressure control
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| Format: | Artículo científico |
| Language: | en |
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Centro de investigaciones y Publicaciones Farmacéuticas
2006
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| _version_ | 1876459163032223744 |
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| author | Caroline E. Kicklighter |
| author_facet | Caroline E. Kicklighter |
| contents | An evaluation of a clinical pharmacy-directed intervention on blood pressure control Caroline E. Kicklighter Kent M. Nelson Tammy L. Humphries Thomas Delate Medicina Hypertension Blood pressure Professional Role Pharmaceutical Services Objective: To compare short and long term bloodpressure control with clinical pharmacy specialistinvolvement to traditional physician management.Setting: A non-profit health maintenanceorganization in the United States coveringapproximately 385,000 lives.Methods: This analysis utilized a prospectiveparallel design. Adult patients with a baseline Bloodpressure≥140/90 mmHg and receiving at least oneantihypertensive medication were eligible for thestudy. Eligible hypertension management patientsat one medical office were referred to the office´sclinical pharmacy specialist (intervention cohort)while at another comparable medical office theyreceived usual physician-directed care (controlcohort). The primary outcome measure wasachievement of a goal BP (<140/90 mmHg) during asix month follow-up. Medical records were alsoreviewed approximately 1.5 years post enrollment toassess long-term BP control after clinical pharmacymanagedpatients returned to usual care.Multivariate analyses were performed to adjust forbaseline cohort differences.Results: One hundred-thirteen and 111 subjects inthe intervention and control cohorts completed thestudy, respectively. At the end of the follow-upperiod, clinical pharmacy-managed subjects weremore likely to have achieved goal BP (64.6%) andreceived a thiazide diuretic (68.1%) compared tocontrol subjects (40.7% and 33.3%, respectively)(adjusted p=0.002 and p<0.001, respectively). Theproportion of clinical pharmacy-managed subjectswith controlled BP decreased to 22.2% afterreturning to usual care (p<0.001).Conclusion: Clinical pharmacy involvement inhypertension management resulted in increased BPcontrol. Loss of long-term control afterdiscontinuation of clinical pharmacy managementsupports a change in care processes that preventpatients from being lost to follow-up. 2006 artículo científico 1885-642X https://www.redalyc.org/articulo.oa?id=69040302 en http://www.redalyc.org/revista.oa?id=690 Pharmacy Practice application/pdf Centro de investigaciones y Publicaciones Farmacéuticas Pharmacy Practice (España) Num.3 Vol.4 |
| format | Artículo científico |
| id | redalyc_69040302 |
| institution | Redalyc |
| language | en |
| publishDate | 2006 |
| publisher | Centro de investigaciones y Publicaciones Farmacéuticas |
| spellingShingle | An evaluation of a clinical pharmacy-directed intervention on blood pressure control Caroline E. Kicklighter Medicina Hypertension Blood pressure Professional Role Pharmaceutical Services An evaluation of a clinical pharmacy-directed intervention on blood pressure control Caroline E. Kicklighter Kent M. Nelson Tammy L. Humphries Thomas Delate Medicina Hypertension Blood pressure Professional Role Pharmaceutical Services Objective: To compare short and long term bloodpressure control with clinical pharmacy specialistinvolvement to traditional physician management.Setting: A non-profit health maintenanceorganization in the United States coveringapproximately 385,000 lives.Methods: This analysis utilized a prospectiveparallel design. Adult patients with a baseline Bloodpressure≥140/90 mmHg and receiving at least oneantihypertensive medication were eligible for thestudy. Eligible hypertension management patientsat one medical office were referred to the office´sclinical pharmacy specialist (intervention cohort)while at another comparable medical office theyreceived usual physician-directed care (controlcohort). The primary outcome measure wasachievement of a goal BP (<140/90 mmHg) during asix month follow-up. Medical records were alsoreviewed approximately 1.5 years post enrollment toassess long-term BP control after clinical pharmacymanagedpatients returned to usual care.Multivariate analyses were performed to adjust forbaseline cohort differences.Results: One hundred-thirteen and 111 subjects inthe intervention and control cohorts completed thestudy, respectively. At the end of the follow-upperiod, clinical pharmacy-managed subjects weremore likely to have achieved goal BP (64.6%) andreceived a thiazide diuretic (68.1%) compared tocontrol subjects (40.7% and 33.3%, respectively)(adjusted p=0.002 and p<0.001, respectively). Theproportion of clinical pharmacy-managed subjectswith controlled BP decreased to 22.2% afterreturning to usual care (p<0.001).Conclusion: Clinical pharmacy involvement inhypertension management resulted in increased BPcontrol. Loss of long-term control afterdiscontinuation of clinical pharmacy managementsupports a change in care processes that preventpatients from being lost to follow-up. 2006 artículo científico 1885-642X https://www.redalyc.org/articulo.oa?id=69040302 en http://www.redalyc.org/revista.oa?id=690 Pharmacy Practice application/pdf Centro de investigaciones y Publicaciones Farmacéuticas Pharmacy Practice (España) Num.3 Vol.4 |
| title | An evaluation of a clinical pharmacy-directed intervention on blood pressure control |
| topic | Medicina Hypertension Blood pressure Professional Role Pharmaceutical Services |
| url | https://www.redalyc.org/articulo.oa?id=69040302 |