Open AccessPhysician‐Pharmacist Co‐Management and 24‐Hour Blood Pressure Control
Author(s) -
Chen Ziqian,
Ernst Michael E.,
Ardery Gail,
Xu Yinghui,
Carter Barry L.
Publication year - 2013
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.12077
Subject(s) - medicine , ambulatory , diuretic , blood pressure , ambulatory blood pressure , pharmacist , randomized controlled trial , physical therapy , pharmacy , nursing
The objectives of this study were to compare indices of 24‐hour blood pressure ( BP) following a physician‐pharmacist collaborative intervention and to describe the associated changes in antihypertensive medications. This was a secondary analysis of a prospective, cluster‐randomized clinical trial conducted in 6 family medicine clinics randomized to co‐managed (n=3 clinics, 176 patients) or control (n=3 clinics, 198 patients) groups. Mean ambulatory systolic BP (SBP) was significantly lower in the co‐managed vs the control group: daytime BP 122.8 mm Hg vs 134.4 mm Hg ( P <.001); nighttime SBP 114.8 mm Hg vs 123.7 mm Hg ( P <.001); and 24‐hour SBP 120.4 mm Hg vs 131.8 mm Hg ( P <.001), respectively. Significantly more drug changes were made in the co‐managed than in the control group (2.7 vs 1.1 changes per patient, P <.001), and there was greater diuretic use in co‐managed patients (79.6% vs 62.6%, P <.001). Ambulatory BP s were significantly lower for the patients who had a diuretic added during the first month compared with those who never had a diuretic added ( P <.01). Physician‐pharmacist co‐management significantly improved ambulatory BP compared with the control group. Antihypertensive drug therapy was intensified much more for patients in the co‐managed group.