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Clinical Trial
. 1998 Nov;13(11):740-5.
doi: 10.1046/j.1525-1497.1998.00225.x.

Comparing standard care with a physician and pharmacist team approach for uncontrolled hypertension

P E Bogden  1 , R D Abbott, P Williamson, J K Onopa, L M Koontz
Affiliations
Clinical Trial

Comparing standard care with a physician and pharmacist team approach for uncontrolled hypertension

P E Bogden et al. J Gen Intern Med. 1998 Nov.

Abstract

Objective: To assess the effect of a physician and pharmacist teamwork approach to uncontrolled hypertension in a medical resident teaching clinic, for patients who failed to meet the recommended goals of the fifth Joint National Commission on Detection, Evaluation and Treatment of High Blood Pressure.

Hypothesis: Physician and pharmacist teamwork can improve the rate of meeting national blood pressure goals in patients with previously uncontrolled hypertension.

Design: A single-blinded randomized controlled trial lasting 6 months.

Setting: A primary care outpatient teaching clinic.

Patients: A sample of 95 adult hypertensive patients who failed to meet national blood pressure goals based on three consecutive visits over a 6-month period.

Intervention: Patients were randomly assigned to a control arm of standard medical care or to an intervention arm in which a physician and pharmacist worked together as a team.

Main results: At study completion, the percentage of patients achieving national goals due to intervention was more than double the percentage in the control arm (55% vs 20%, p < .001). Systolic blood pressure declined 23 mm Hg in the intervention arm versus 11 mm Hg in the control arm (p < .01). Diastolic blood pressure declined 14 and 3 mm Hg in the intervention and control arms, respectively (p < .001). The intervention worked equally as well in men and women and demonstrated noticeable promise in a minority of mixed-ancestry Hawaiians in whom hypertension is of special concern.

Conclusions: Patients who fail to achieve national blood pressure goals under standard outpatient medical care may benefit from a program that includes a physician and pharmacist teamwork approach.

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Figures

Figure 1
Figure 1
Percentage of patients who achieved JNC-V target blood pressure goals of less than 1 40 mm Hg for systolic blood pressure and less than 90 mm Hg for diastolic blood pressure in the control and intervention groups.
Figure 2
Figure 2
Mean reduction in systolic and diastolic blood pressures for control and intervention groups.
See this image and copyright information in PMC

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