Pharmacist-Directed Self-Management of Blood Pressure Versus Conventional Management in Patients with Hypertension: A Randomized Control Trial.

Abstract

Data has shown that pharmacist-directed health services play a key role in the treatment of hypertension. We aimed to perform this study to compare two methods of the pharmacist-directed home blood pressure monitoring (HBPM) and the usual care. A total of 126 patients with uncontrolled blood pressure (BP) were randomized 1:1 into the pharmacist-directed HBPM and the usual care groups. In the intervention group, the patients were trained to measure their BPs and adjust their medications based on the designed protocol under the supervision of a clinical pharmacist. The primary endpoint of the study was the comparison of the BPs at baseline and months 1, 3, and 6. One month after the allocation, the baseline systolic BP (SBP) (150.5 ± 13.1 vs. 149.7 ± 11.2mm Hg; P = 0.71) and diastolic BP (DBP) (97.2 ± 9.8 vs. 93.6 ± 14.5; P = 0.11) significantly dropped to the control range equally in 85.2% of the patients in two groups (SBP: 128.8 ± 6.4 vs. 125.6 ± 7.1mm Hg; P = 0.01 and DBP: 89.1 ± 6.2 vs. 81.5 ± 6.0mm Hg; P = 0.01). This pattern continued during the study period (month 6; SBP: 115.6 ± 10.1vs. 116.1 ± 9.6mm Hg; P = 0.78; DBP: 79.0 ± 5.0 vs. 77.2 ± 5.8mm Hg; P = 0.08). In this study, we did not observe any significant difference between the pharmacist-directed HBPM and usual care methods in decreasing BP.