title: Physician-pharmacist collaboration versus usual care for treatment-resistant hypertension.
abstract: Team-based care has been recommended for patients with treatment-resistant hypertension (TRH), but its efficacy in this setting is unknown. We compared a physician-pharmacist collaborative model (PPCM) to usual care in patients with TRH participating in the Collaboration Among Pharmacists and Physicians To Improve Outcomes Now study. At baseline, 169 patients (27% of Collaboration Among Pharmacists and Physicians To Improve Outcomes Now patients) had TRH: 111 received the PPCM intervention and 58 received usual care. Baseline characteristics were similar between treatment arms. After 9 months, adjusted mean systolic blood pressure was reduced by 7 mm Hg more with PPCM intervention than usual care (P = .036). Blood pressure control was 34.2% with PPCM versus 25.9% with usual care (adjusted odds ratio, 1.92; 95% confidence interval, 0.33-11.2). These findings suggest that team-based care in the primary care setting may be effective for TRH. Additional research is needed regarding the long-term impact of these models and to identify patients most likely to benefit from team-based interventions.
authors: Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, FL, USA; Department of Community Health & Family Medicine, College of Medicine, University of Florida, Gainesville, FL, USA. Electronic address: ssmith@cop.ufl.edu.
authors: Steven M
authors: SM
authors: Smith
authors: Department of Pharmacotherapeutics and Clinical Research, College of Pharmacy, University of South Florida, Tampa, FL, USA; Department of Family Medicine, College of Medicine, University of South Florida, Tampa, FL, USA.
authors: Nicholas W
authors: NW
authors: Carris
authors: Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, FL, USA; Department of Community Health & Family Medicine, College of Medicine, University of Florida, Gainesville, FL, USA.
authors: Eric
authors: E
authors: Dietrich
authors: Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, FL, USA; Department of Community Health & Family Medicine, College of Medicine, University of Florida, Gainesville, FL, USA.
authors: John G
authors: JG
authors: Gums
authors: Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA.
authors: Liz
authors: L
authors: Uribe
authors: Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA.
authors: Christopher S
authors: CS
authors: Coffey
authors: 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: Tyler H
authors: TH
authors: Gums
authors: 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: Barry L
authors: BL
authors: Carter
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001795:Blood Pressure Determination; D003329:Coronary Vasospasm / Q000188:drug therapy*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D000070516:Intersectoral Collaboration; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D010595:Pharmacists; D010820:Physicians; D011320:Primary Health Care / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents
keywords: Collaborative care; hypertension; pharmacist; treatment-resistant hypertension