Pharmacist intervention for blood pressure control: medication intensification and adherence

被引:28
|
作者
Gums, Tyler H. [1 ,2 ]
Uribe, Liz [3 ]
Vander Weg, Mark W. [4 ,5 ,6 ]
James, Paul [2 ]
Coffey, Christopher [3 ]
Carter, Barry L. [1 ,2 ]
机构
[1] Univ Iowa, Coll Pharm, Dept Pharm Practice & Sci, Iowa City, IA 52242 USA
[2] Univ Iowa, Roy J & Lucille A Carver Coll Med, Dept Family Med, Iowa City, IA 52242 USA
[3] Univ Iowa, Coll Publ Hlth, Dept Biostat, Iowa City, IA 52242 USA
[4] Univ Iowa, Roy J & Lucille A Carver Coll Med, Dept Internal Med, Iowa City, IA 52242 USA
[5] Iowa City VA Hlth Care Syst, Ctr Comprehens Access & Delivery Res & Evaluat CA, Iowa City, IA USA
[6] Univ Iowa, Coll Liberal Arts & Sci, Dept Psychol, Iowa City, IA 52242 USA
关键词
Collaboration; hypertension; team-based care; CLUSTER-RANDOMIZED-TRIAL; HYPERTENSIVE PATIENTS; COLLABORATIVE MODEL; CARE; PHYSICIAN; HEART; INDIVIDUALS; MANAGEMENT; THERAPY; TRENDS;
D O I
10.1016/j.jash.2015.05.005
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
The objective of this study was to describe medication adherence and medication intensification in a physician-pharmacist collaborative management (PPCM) model compared with usual care. This study was a prospective, cluster, randomized study in 32 primary care offices from 15 states. The primary outcomes were medication adherence and anti-hypertensive medication changes during the first 9 months of the intervention. The 9-month visit was completed by 539 patients, 345 of which received the intervention. There was no significant difference between intervention and usual care patients in regards to medication adherence at 9 months. Intervention patients received significantly more medication changes (4.9 vs. 1.1; P = .0003) and had significantly increased use of diuretics and aldosterone antagonists when compared with usual care (P = .01).The PPCM model increased medication intensification; however, no significant change in medication adherence was detected. PPCM models will need to develop non-adherence identification and intervention methods to further improve the potency of the care team. (C) 2015 American Society of Hypertension. All rights reserved.
引用
收藏
页码:569 / 578
页数:10
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