Effect of a Clinical Pharmacist–Managed Service on Blood Pressure in an Underserved Population With Resistant Hypertension

Abstract

Background. Evidence indicates pharmacist-managed hypertension clinics are beneficial in reducing blood pressure (BP). There is currently no evidence evaluating the effect of pharmacist-managed resistant hypertension clinics in a medically underserved patient population. Objective. To determine the impact of a pharmacist-managed resistant hypertension service on BP in a medically underserved population. Methods. This was a prospective cohort study evaluating 12 medically underserved patients enrolled in a pharmacist-managed resistant hypertension service at the St Louis County Department of Health. BP was measured in clinic and at home. Follow-up occurred biweekly by phone and in clinic at least monthly while uncontrolled. This study was approved by the St Louis College of Pharmacy Institutional Review Board and St Louis County Department of Health director for clinical and research services. Primary outcome of change in home systolic BP and secondary outcomes of change in home diastolic BP and clinic systolic and diastolic BP were evaluated. Results. Twelve patients were included in the analysis (2 patients did not receive home BP monitors). Home systolic BP was reduced from the first encounter, 140 (12) mm Hg, to last contact, 130 (15) mm Hg ( P = .01). Clinic systolic BP also decreased significantly from the first encounter, 152 (10) mm Hg, to last contact, 136 (17) mm Hg ( P = .004). Clinic BP goal and home BP goal was attained by 30% and 40% of participants, respectively. Conclusions. A pharmacist-managed resistant hypertension service is effective in significantly reducing BP in medically underserved patients.