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Randomized Controlled Trial
. 2008 Apr;10(4):260-71.
doi: 10.1111/j.1751-7176.2008.07434.x.

A cluster randomized trial to evaluate physician/pharmacist collaboration to improve blood pressure control

Barry L Carter  1 , George R Bergus, Jeffrey D Dawson, Karen B Farris, William R Doucette, Elizabeth A Chrischilles, Arthur J Hartz
Affiliations
Randomized Controlled Trial

A cluster randomized trial to evaluate physician/pharmacist collaboration to improve blood pressure control

Barry L Carter et al. J Clin Hypertens (Greenwich). 2008 Apr.

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.

Trial registration: ClinicalTrials.gov NCT00201045.

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Figures

Figure 1
Figure 1
Flow of patients through the study protocol. BP indicates blood pressure; WCH, white‐coat hypertension.
Figure 2
Figure 2
Clinic‐measured systolic blood pressure (SBP) levels by visit.
Figure 3
Figure 3
Blood pressure (BP) control based on clinic blood pressure values. Goal BP in patients with uncomplicated hypertension was <140/90 mm Hg, and in patients with diabetes or chronic kidney disease, goal BP was <130/80 mm Hg.
See this image and copyright information in PMC

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