Abstract P105: A Pharmacist Guided Patient Driven Interdisciplinary Program to Improve Blood Pressure Control in Patients with Hypertension

Abstract

Introduction: Approximately 65% of patients treated for hypertension do not meet blood pressure goals. New strategies are needed to improve this number given the high impact of hypertension on CV disease. Dietary approaches and patient-driven self-titration of BP medications have been shown to be effective and safe in clinical studies but are under utilized in clinical practice. We present our experience with this ongoing project. Aims: Implement a pharmacist-guided, patient-driven self-monitoring and medication titration program. Implement standardized evidence-based dietary counseling to hypertensive patients. Intervention: Patients with uncontrolled hypertension on 3 or fewer anti-hypertensive agents were contacted to participate. BP goals were established based on individual risk factors. Patients were referred to the clinical pharmacist who devised a personalized plan for BP medication titration. Provide Education on dietary modification was provided to patients. The project was first introduced at the University of Colorado Hospital CKD clinic and then transitioned to the primary care setting at A.F. Williams Family Medicine Center. Outcomes: Appeal--both to providers and patients via pre/post survey Adherence/effectiveness--tracked via patient EMR blood pressure entries Adverse Events (via survey) experienced by patients will be analyzed. Results: At time of submission 19 patients have been enrolled and 3 patients have completed 6 month follow-up visits Of all ongoing and completed patients adherence to protocol is 72.2% 2 of the 3 patients completing 6 month follow-up had significant improvement in blood pressure (avg 16.26 mmHG) Comparison of descriptive statistics gathered from pre and 6 mo program provider surveys suggest favorable acceptance of program from renal providers All patients enrolled received dietary counseling with 3 patients receiving formal dietary consults. Conclusion: Our model for self-titration and dietary counseling appears to be feasible, safe and well received from providers. At the time of submission this project is ongoing, however early results from patients completing the protocol appear to be promising.