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Randomized Controlled Trial
. 2016 Nov;68(5):1314-1320.
doi: 10.1161/HYPERTENSIONAHA.116.08043. Epub 2016 Sep 6.

Physician-Pharmacist Collaborative Management: Narrowing the Socioeconomic Blood Pressure Gap

Maxwell D Anderegg  1 , Tyler H Gums  1 , Liz Uribe  1 , Christopher S Coffey  1 , Paul A James  1 , Barry L Carter  2
Affiliations
Randomized Controlled Trial

Physician-Pharmacist Collaborative Management: Narrowing the Socioeconomic Blood Pressure Gap

Maxwell D Anderegg et al. Hypertension. 2016 Nov.

Abstract

Physician-pharmacist collaboration improves blood pressure, but there is little information on whether this model can reduce the gap in healthcare disparities. This trial involved 32 medical offices in 15 states. A clinical pharmacist was embedded within each office and made recommendations to physicians and patients in intervention offices. The purpose of the present analysis was to evaluate whether the pharmacist intervention could reduce healthcare disparities by improving blood pressure in high-risk racial and socioeconomic subjects compared with the control group. The analyses in minority subjects were prespecified secondary analyses, but all other comparisons were secondary, post hoc analyses. The 9-month visit was completed by 539 patients: 345 received the intervention, and 194 were in the control group. Following the intervention, mean systolic blood pressure was found to be 7.3 mm Hg (95% confidence interval 2.4, 12.3) lower in subjects from racial minority groups who received the intervention compared with the control group (P=0.0042). Subjects with ≤12 years of education in the intervention group had a systolic blood pressure 8.1 mm Hg (95% confidence interval 3.2, 13.1) lower than the control group with lower education (P=0.0001). Similar reductions in blood pressure occurred in patients with low incomes, those receiving Medicaid, or those without insurance. This study demonstrated that a pharmacist intervention reduced racial and socioeconomic disparities in the treatment of blood pressure. Although disparities in blood pressure were reduced by the intervention, there were still nonsignificant gaps in mean systolic blood pressure when compared with intervention subjects not at risk.

Clinical trial registration: URL: http://clinicaltrials.gov. Unique identifier: NCT00935077.

Keywords: blood pressure; healthcare disparities; minority populations; pharmacist intervention; team care.

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Conflict of interest statement

Authors of this paper have nothing to disclose concerning possible financial or personal relationships with commercial entities that may have a direct or indirect interest in the subject matter of this manuscript.

Figures

Figure 1
Figure 1
Consort Statement of Clinic Randomization and Subject Participation
Figure 2
Figure 2
Mean systolic BP at Baseline and 9 months by Minority Status
Figure 3
Figure 3
Mean systolic BP at Baseline and 9 months by Level of Education
Figure 4
Figure 4
Mean systolic BP at Baseline and 9 months and Income Class
Figure 5
Figure 5
Mean systolic BP at Baseline and 9 months Collapsed by Insurance Status
See this image and copyright information in PMC

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