Physician-pharmacist co-management and 24-hour blood pressure control

Ziqian Chen; Michael E Ernst; Gail Ardery; Yinghui Xu; Barry L Carter

doi:10.1111/jch.12077

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Physician-pharmacist co-management and 24-hour blood pressure control

Journal article

Open access

Peer reviewed

Physician-pharmacist co-management and 24-hour blood pressure control

Ziqian Chen, Michael E Ernst, Gail Ardery, Yinghui Xu and Barry L Carter

The journal of clinical hypertension (Greenwich, Conn.), Vol.15(5), pp.337-343

05/2013

DOI: 10.1111/jch.12077

PMCID: PMC3641686

PMID: 23614849

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3641686View

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Abstract

The objectives of this study were to compare indices of 24-hour blood pressure (BP) following a physician-pharmacist collaborative intervention and to describe the associated changes in antihypertensive medications. This was a secondary analysis of a prospective, cluster-randomized clinical trial conducted in 6 family medicine clinics randomized to co-managed (n=3 clinics, 176 patients) or control (n=3 clinics, 198 patients) groups. Mean ambulatory systolic BP (SBP) was significantly lower in the co-managed vs the control group: daytime BP 122.8 mm Hg vs 134.4 mm Hg (P<.001); nighttime SBP 114.8 mm Hg vs 123.7 mm Hg (P<.001); and 24-hour SBP 120.4 mm Hg vs 131.8 mm Hg (P<.001), respectively. Significantly more drug changes were made in the co-managed than in the control group (2.7 vs 1.1 changes per patient, P<.001), and there was greater diuretic use in co-managed patients (79.6% vs 62.6%, P<.001). Ambulatory BPs were significantly lower for the patients who had a diuretic added during the first month compared with those who never had a diuretic added (P<.01). Physician-pharmacist co-management significantly improved ambulatory BP compared with the control group. Antihypertensive drug therapy was intensified much more for patients in the co-managed group.

Adult

Aged

Antihypertensive Agents - therapeutic use

Blood Pressure - drug effects

Blood Pressure Monitoring, Ambulatory - methods

Female

Humans

Hypertension - prevention & control

Male

Middle Aged

Patient Care Team - organization & administration

Pharmacists

Physicians

Primary Health Care - methods

Prospective Studies

Details

Title: Subtitle: Physician-pharmacist co-management and 24-hour blood pressure control
Creators: Ziqian Chen - University of Iowa
Michael E Ernst - University of Iowa
Gail Ardery - University of Iowa
Yinghui Xu - Roy J. and Lucille A. Carver College of Medicine
Barry L Carter - University of Iowa
Resource Type: Journal article
Publication Details: The journal of clinical hypertension (Greenwich, Conn.), Vol.15(5), pp.337-343
DOI: 10.1111/jch.12077
PMID: 23614849
PMCID: PMC3641686
NLM abbreviation: J Clin Hypertens (Greenwich)
ISSN: 1524-6175
eISSN: 1751-7176
Grant note: R01 HL069801 / NHLBI NIH HHS HL069801 / NHLBI NIH HHS HL070740 / NHLBI NIH HHS R01 HL070740 / NHLBI NIH HHS U18 HS016094 / AHRQ HHS 5U18HSO16094 / PHS HHS
Language: English
Date published: 05/2013
Academic Unit: Family and Community Medicine; Pharmacy Practice and Science
Record Identifier: 9984297447302771

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