Abstract P207: The Feasibility Of A 6-week, Pharmacist-Led, Self-Monitored Blood Pressure Treatment Program

Abstract

Background: Guidelines recommend concomitant out-of-office blood pressure (BP) measurements with telehealth counseling for titration. While high quality home BP measurement coupled with pharmacist care reduces the time needed to achieve BP goal, it remains unclear how rapidly BP titrations can be applied in clinical practice. Objective: To examine the impact of home BP monitoring coupled with a rapid, biweekly, pharmacist-led BP medication titration program on BP control and patient safety. Methods: Forty patients were referred if BP ≥140/90, using ≤2 anti-hypertensive medications, and failed a trial of lifestyle modification. The initial visit with the pharmacist included validation of home BP monitor compared with an Omron HEM-907XL. Patients monitored BP twice daily in the morning and evening for a week then had their medication regimen adjusted every 2 weeks until reaching their goal or completing a 6-week follow-up period. Results: Of the 29 patients completing the program, mean enrollment SBP/DBP was 155.2 (SD, 15.8)/89.7 (SD, 11.5) mm Hg. The completion SBP/DBP was 132.1 (SD, 10.9)/ 77.6 (SD, 10). The number of HTN medications prescribed increased by an average of 0.3 (from 1.3 to 1.6) over the follow-up period. There were no incidences of falls or hypotension. One patient had a clinically significant electrolyte change requiring medication adjustment. Two patients had a clinically significant change in serum creatinine, but both stabilized after altering their hypertension medication regimen. Conclusion: A 6-week, pharmacist-led, home BP monitoring program with rapid titration had high retention and increased the percentage of patients achieving BP goals without safety concerns.