Journal of General Internal Medicine

, Volume 13, Issue 11, pp 740–745

Comparing standard care with a physician and pharmacist team approach for uncontrolled hypertension

  • Paul E. Bogden
  • Robert D. Abbott
  • Pam Williamson
  • Janet K. Onopa
  • Leann M. Koontz
Original Articles

DOI: 10.1046/j.1525-1497.1998.00225.x

Cite this article as:
Bogden, P.E., Abbott, R.D., Williamson, P. et al. J GEN INTERN MED (1998) 13: 740. doi:10.1046/j.1525-1497.1998.00225.x

Abstract

OBJECTIVE: To assess the effect of a physician and pharmacist teamwork approach to uncontrolled hypertension in a medical resident teaching clinic, for patients who failed to meet the recommended goals of the fifth Joint National Commission on Detection, Evaluation and Treatment of High Blood Pressure.

HYPOTHESIS: Physician and pharmacist teamwork can improve the rate of meeting national blood pressure goals in patients with previously uncontrolled hypertension.

DESIGN: A single-blinded randomized controlled trial lasting 6 months.

SETTING: A primary care outpatient teaching clinic.

PATIENTS: A sample of 95 adult hypertensive patients who failed to meet national blood pressure goals based on three consecutive visits over a 6-month period.

INTERVENTION: Patients were randomly assigned to a control arm of standard medical care or to an intervention arm in which a physician and pharmacist worked together as a team.

MAIN RESULTS: At study completion, the percentage of patients achieving national goals due to intervention was more than double the percentage in the control arm (55% vs 20%, p < .001). Systolic blood pressure declined 23 mm Hg in the intervention arm versus 11 mm Hg in the control arm (p < .01). Diastolic blood pressure declined 14 and 3 mm Hg in the intervention and control arms, respectively (p < .001). The intervention worked equally as well in men and women and demonstrated noticeable promise in a minority of mixed-ancestry Hawaiians in whom hypertension is of special concern.

CONCLUSIONS: Patients who fail to achieve national blood pressure goals under standard outpatient medical care may benefit from a program that includes a physician and pharmacist teamwork approach.

Key words

blood pressurecoronary heart diseaserisk factorpharmacistambulatory care

Copyright information

© Society of General Internal Medicine 1998

Authors and Affiliations

  • Paul E. Bogden
    • 1
    • 2
  • Robert D. Abbott
    • 1
    • 4
    • 5
  • Pam Williamson
    • 2
    • 3
  • Janet K. Onopa
    • 1
    • 2
  • Leann M. Koontz
    • 2
  1. 1.the Department of Medicine, John A. Burns School of MedicineUniversity of HawaiiHonolulu
  2. 2.The Queen’s Medical CenterHonolulu
  3. 3.Northern Virginia Kaiser PermanenteSpringfield
  4. 4.the Division of BiostatisticsUniversity of Virginia School of MedicineCharlottesville
  5. 5.the School of NursingUniversity of HawaiiHonolulu
  6. 6.University of Hawaii Integrated Medical Residency ProgramHonolulu