title: Pharmacists on primary care teams: Effect on antihypertensive medication management in patients with type 2 diabetes.
abstract: OBJECTIVE
  To identify which activities produced a significant improvement in blood pressure control in patients with type 2 diabetes when pharmacists were added to primary care teams.
  
  
  METHODS
  This prespecified, secondary analysis evaluated medication management data from a randomized controlled trial. The primary outcome was a change in treatment, defined as addition, dosage increase, or switching of an antihypertensive medication during the 1-year study period. The secondary outcome was a change in antihypertensive medication adherence using the medication possession ratio (MPR).
  
  
  RESULTS
  The 200 evaluable trial patients had a mean age of 59 (SD, 11) years, 44% were men, and mean blood pressure was 130 (SD, 16)/74 (SD, 10) mm Hg at baseline. Treatment changes occurred in 45 (42%) of 107 patients in the intervention group and 24 (26%) of 93 patients in the control group (RR, 1.63; 95% CI, 1.08-2.46). Addition of a new medication was the most common type of change, occurring in 34 (32%) patients in the intervention group and 17 (18%) patients in the control group (P = 0.029). Adherence to antihypertensive medication was high at baseline (MPR, 93%). Although medication adherence improved in the intervention group (MPR, 97%) and declined in the control group (MPR, 91%), the difference between groups was not significant (P = 0.21).
  
  
  CONCLUSIONS
  The observed improvement in blood pressure control when pharmacists were added to primary care teams was likely achieved through antihypertensive treatment changes and not through improvements in antihypertensive medication adherence.
authors.forename: Dima
authors.initials: D
authors.lastname: Omran
authors.forename: Sumit R
authors.initials: SR
authors.lastname: Majumdar
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Johnson
authors.forename: Ross T
authors.initials: RT
authors.lastname: Tsuyuki
authors.forename: Richard Z
authors.initials: RZ
authors.lastname: Lewanczuk
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Guirguis
authors.forename: Mark
authors.initials: M
authors.lastname: Makowsky
authors.forename: Scot H
authors.initials: SH
authors.lastname: Simpson
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D054539:Medication Therapy Management / Q000458:organization & administration*; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration*; D010595:Pharmacists; D011320:Primary Health Care / Q000458:organization & administration*
chemical_list: D000959:Antihypertensive Agents