title: Physician Acceptance of a Physician-Pharmacist Collaborative Treatment Model for Hypertension Management in Primary Care.
abstract: Physician-pharmacist collaborative care (PPCC) is effective in improving blood pressure (BP) control, but primary care provider (PCP) engagement in such models has not been well-studied. The authors analyzed data from PPCC referrals to 108 PCPs, for patients with uncontrolled hypertension, assessing the proportion of referral requests approved, disapproved, and not responded to, and reasons for disapproval. Of 2232 persons with uncontrolled hypertension, PPCC referral requests were sent for 1516 (67.9%): 950 (62.7%) were approved, 406 (26.8%) were disapproved, and 160 (10.6%) received no response. Approval rates differed widely by PCP with a median approval rate of 75% (interquartile range, 41%-100%). The most common reasons for disapproval were: PCP prefers to manage hypertension (19%), and BP controlled per PCP (18%); 8% of cases were considered too complex for PPCC. Provider acceptance of a PPCC hypertension clinic was generally high and sustained but varied widely among PCPs. No single reason for disapproval predominated.
authors.affiliation: Departments of Pharmacotherapy & Translational Research and Community Health & Family Medicine, Colleges of Pharmacy and Medicine, University of Florida, Gainesville, FL.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Smith
authors.affiliation: Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO.
authors.forename: Michaela
authors.initials: M
authors.lastname: Hasan
authors.affiliation: Center for Women's Health Research, School of Medicine, University of Colorado, Aurora, CO.|Division of General Internal Medicine, School of Medicine, University of Colorado, Aurora, CO.
authors.forename: Amy G
authors.initials: AG
authors.lastname: Huebschmann
authors.affiliation: Division of General Internal Medicine, School of Medicine, University of Colorado, Aurora, CO.
authors.forename: Richard
authors.initials: R
authors.lastname: Penaloza
authors.affiliation: Division of General Internal Medicine, School of Medicine, University of Colorado, Aurora, CO.
authors.forename: Wagner
authors.initials: W
authors.lastname: Schorr-Ratzlaff
authors.affiliation: Division of General Internal Medicine, School of Medicine, University of Colorado, Aurora, CO.
authors.forename: Amber
authors.initials: A
authors.lastname: Sieja
authors.affiliation: Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO.
authors.forename: Nicholai
authors.initials: N
authors.lastname: Roscoe
authors.affiliation: Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO.|Department of Medicine, School of Medicine, University of Colorado, Aurora, CO.
authors.forename: Katy E
authors.initials: KE
authors.lastname: Trinkley
mesh_terms: D003299:Cooperative Behavior; D019468:Disease Management; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D007400:Interprofessional Relations; D008297:Male; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team; D010595:Pharmacists / Q000523:psychology* / Q000706:statistics & numerical data; D010820:Physicians / Q000523:psychology* / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000379:methods; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology