Impact of a pharmacist‐physician collaborative care model on time‐in‐therapeutic blood pressure range in patients with hypertension

Abstract

AbstractIntroductionAlthough pharmacist‐physician collaborative care models (PPCCM) improve mean blood pressure (BP) and goal attainment rates, the impact of these models on time‐in‐therapeutic blood pressure range (TTBPR) is unknown.ObjectivesThe primary objective of this study was to determine the effect of a PPCCM on TTBPR compared with a usual care group.MethodsThis post‐hoc analysis compared data obtained from two retrospective groups of patients with uncontrolled hypertension managed either by a PPCCM or usual care. The primary end point was TTBPR, defined as the proportion of clinic visits with a systolic BP between 120 and 140 mmHg over a 12‐month follow‐up period. Several secondary end points were also evaluated. Means were compared using a t‐test, while counts and comparisons were compared using chi‐square or Fisher exact test.ResultsThe study included 56 patients and 56 controls matched by gender, baseline systolic BP, and history of cardiovascular disease. Mean age was 58 years, 37.5% were female, and 73% were black. The mean TTBPR was 46.2% ± 24.3% in the PPCCM group and 24.8% ± 27.4% in the usual care group (P < 0.0001). Therapeutic inertia was 20.1% in the PPCCM compared with 48.1% in the usual care group (P < 0.0001). Greater reductions in BP were observed in the PPCCM group compared with usual care (systolic BP: −27.8 vs −11.4 mmHg, respectively; P < 0.0001; diastolic BP: −19.2 vs −4.2 mmHg, respectively; P < 0.0001). The BP control rates at 12 months were 89% in the PPCCM compared with 50% in the usual care group (P < 0.0001).ConclusionPatients exposed to a PPCCM had higher TTBPR compared with those who received usual care. The PPCCM group also had a lower rate of therapeutic inertia, greater reductions in BP, and achieved a higher percentage of patients at goal BP in an urban, underserved population.