title: Pharmacist intervention for blood pressure control: medication intensification and adherence.
abstract: The objective of this study was to describe medication adherence and medication intensification in a physician-pharmacist collaborative management (PPCM) model compared with usual care. This study was a prospective, cluster, randomized study in 32 primary care offices from 15 states. The primary outcomes were medication adherence and anti-hypertensive medication changes during the first 9 months of the intervention. The 9-month visit was completed by 539 patients, 345 of which received the intervention. There was no significant difference between intervention and usual care patients in regards to medication adherence at 9 months. Intervention patients received significantly more medication changes (4.9 vs.1.1; P = .0003) and had significantly increased use of diuretics and aldosterone antagonists when compared with usual care (P = .01).The PPCM model increased medication intensification; however, no significant change in medication adherence was detected. PPCM models will need to develop non-adherence identification and intervention methods to further improve the potency of the care team.
authors.affiliation: Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, IA, USA; Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USA. Electronic address: tyler-gums@uiowa.edu.
authors.forename: Tyler H
authors.initials: TH
authors.lastname: Gums
authors.affiliation: Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA.
authors.forename: Liz
authors.initials: L
authors.lastname: Uribe
authors.affiliation: Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USA; Center for Comprehensive Access and Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, IA, USA; Department of Psychology, College of Liberal Arts and Sciences, University of Iowa, Iowa City, IA, USA.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Vander Weg
authors.affiliation: Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: James
authors.affiliation: Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Coffey
authors.affiliation: Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, IA, USA; Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
authors.forename: Barry L
authors.initials: BL
authors.lastname: Carter
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003299:Cooperative Behavior; D004232:Diuretics / Q000627:therapeutic use; D004346:Drug Information Services; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D010353:Patient Education as Topic; D010595:Pharmacists; D011320:Primary Health Care; D011446:Prospective Studies; D014481:United States; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents; D004232:Diuretics; D000451:Mineralocorticoid Receptor Antagonists
keywords: Collaboration; hypertension; team-based care