title: A cluster randomized trial to evaluate physician/pharmacist collaboration to improve blood pressure control.
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.
authors.affiliation: Division of Clinical and Administrative Pharmacy, College of Pharmacy, University of Iowa, Iowa City, IA 52242, USA. barry.carter@uiowa.edu
authors.forename: Barry L
authors.initials: BL
authors.lastname: Carter
authors.forename: George R
authors.initials: GR
authors.lastname: Bergus
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Dawson
authors.forename: Karen B
authors.initials: KB
authors.lastname: Farris
authors.forename: William R
authors.initials: WR
authors.lastname: Doucette
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Chrischilles
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Hartz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D016000:Cluster Analysis; D003299:Cooperative Behavior; D004521:Educational Measurement; D005260:Female; D006801:Humans; D006973:Hypertension / Q000517:prevention & control*; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D010595:Pharmacists; D010820:Physicians; D011446:Prospective Studies; D013599:Systole