STUDY OBJECTIVE: To assess the effectiveness of a pharmacist-managed service in improving hypertension control among patients with coronary artery disease. DESIGN: Prospective cohort study. Setting. Health maintenance organization. PATIENTS: Three hundred seventy-six patients with uncontrolled hypertension and coronary artery disease. INTERVENTION: Pharmacist-managed, physician-supervised population-management approach to optimize evidence-based drug management. MEASUREMENTS AND MAIN RESULTS: Blood pressure reduction and control were evaluated, as well as the use of angiotensin-converting enzyme inhibitors and generic antihypertensive drugs during 7-month follow-up. At baseline, mean +/- SD age was 70.4 +/- 8.8 years, 247 (65.7%) were men, 201 (53.5%) had a history of myocardial infarction, and 237 (63.0%) had diabetes mellitus. Baseline mean systolic blood pressure was 151 mm Hg, and none had achieved their blood pressure goal. During follow-up, mean systolic blood pressure decreased 16.1 mm Hg overall (p<0.001), and 179 (47.6%) patients achieved their goal blood pressure (p<0.001). Blood pressure reductions were 14.7 and 18.4 mm Hg in patients with and patients without diabetes, respectively (p<0.001). The target dose for angiotensin-converting enzyme inhibitors was achieved in 252 (67.0%) patients compared with 102 (27.1%) at baseline (p<0.001). Generic fill rates for antihypertensive drugs continued to be higher than 95% during follow-up (p=0.723). CONCLUSION: A pharmacist-managed, physician-supervised population-management approach in patients with coronary artery disease significantly improved blood pressure control. Clinically meaningful reductions in blood pressure were achieved by using evidence-based, cost-effective drug regimens.
STUDY OBJECTIVE: To assess the effectiveness of a pharmacist-managed service in improving hypertension control among patients with coronary artery disease. DESIGN: Prospective cohort study. Setting. Health maintenance organization. PATIENTS: Three hundred seventy-six patients with uncontrolled hypertension and coronary artery disease. INTERVENTION: Pharmacist-managed, physician-supervised population-management approach to optimize evidence-based drug management. MEASUREMENTS AND MAIN RESULTS: Blood pressure reduction and control were evaluated, as well as the use of angiotensin-converting enzyme inhibitors and generic antihypertensive drugs during 7-month follow-up. At baseline, mean +/- SD age was 70.4 +/- 8.8 years, 247 (65.7%) were men, 201 (53.5%) had a history of myocardial infarction, and 237 (63.0%) had diabetes mellitus. Baseline mean systolic blood pressure was 151 mm Hg, and none had achieved their blood pressure goal. During follow-up, mean systolic blood pressure decreased 16.1 mm Hg overall (p<0.001), and 179 (47.6%) patients achieved their goal blood pressure (p<0.001). Blood pressure reductions were 14.7 and 18.4 mm Hg in patients with and patients without diabetes, respectively (p<0.001). The target dose for angiotensin-converting enzyme inhibitors was achieved in 252 (67.0%) patients compared with 102 (27.1%) at baseline (p<0.001). Generic fill rates for antihypertensive drugs continued to be higher than 95% during follow-up (p=0.723). CONCLUSION: A pharmacist-managed, physician-supervised population-management approach in patients with coronary artery disease significantly improved blood pressure control. Clinically meaningful reductions in blood pressure were achieved by using evidence-based, cost-effective drug regimens.
Authors: Jennifer L Kuntz; Jennifer L Schneider; Alison J Firemark; John F Dickerson; Dea Papajorgji-Taylor; Katherine R Reese; Traci A Hamer; Darlene Marsh; Lou Ann Thorsness; Mark D Sullivan; Lynn L Debar; David H Smith Journal: Perm J Date: 2020-04-21
Authors: Kimberly D Brunisholz; Jeff Olson; Jonathan W Anderson; Emily Hays; Peggy M Tilbury; Bradley Winter; Josh Rickard; Sharon Hamilton; Gregory Parkin Journal: J Int Med Res Date: 2017-08-08 Impact factor: 1.671