Including Pharmacist on Medical Team May Aid Blood Pressure Control

Patients had more medication adjustments if a pharmacist was involved in their care, study finds

By Robert Preidt

Friday, August 7, 2015

FRIDAY, Aug. 7, 2015 (HealthDay News) -- Pharmacists can play an important role in helping patients control high blood pressure, a new study finds.

Researchers followed 625 racially and ethnically diverse Americans with uncontrolled high blood pressure who were seen at 32 medical offices in 15 states. The patients were either cared for by a doctor only, or by a medical team that included a pharmacist.

"Clinical pharmacists were able to contribute to the care team by tailoring blood pressure medications for each patient and spent extra time educating patients on how to decrease their blood pressure," study corresponding author Tyler Gums, a postdoctoral researcher in the University of Iowa College of Pharmacy, said in a university news release.

High blood pressure increases the likelihood of heart disease and stroke, two of the leading causes of death for Americans, the study authors noted.

The pharmacists in the study worked in the medical offices and had long-term relationships with the doctors. It's possible that community pharmacists may not have such close ties with local doctors, the researchers pointed out.

Nine months after starting treatment, patients cared for by medical teams with a clinical pharmacist had a 6.1 mm Hg greater decline in systolic blood pressure -- the top number in a blood pressure reading -- than those who saw doctors only. That difference would reduce the risk of death from stroke by 23 percent, the researchers reported.

Patients cared for by medical teams had their blood pressure medications adjusted nearly five times on average over nine months; three of those adjustments involved dose increases or additional medications, the investigators found.

When a clinical pharmacist was not involved in treatment, patients averaged one medication adjustment and less than one dose increase or added medication, according to the research, which was recently published in the Journal of the American Society of Hypertension.

"We've known for more than 40 years that including pharmacists on medical care teams improved blood pressure control and the management of many chronic conditions," study leader Barry Carter, a pharmacy professor, said in the news release.

"However, we have had little evidence that such programs could be scaled up and implemented in a large number of diverse medical offices, with wide geographic distribution and serving high numbers of minority populations," he explained.

This study address these issues and demonstrates that people from racial and ethnic minority groups known to have worse blood pressure control have had the same degree of improvement as the entire population, Carter said. "We also demonstrated, especially in the minority groups, that the effect could be sustained for a full two years after the intervention ended," he said.

SOURCE: University of Iowa, news release, July 30, 2015

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