Hypertension outcomes through blood pressure monitoring and evaluation by pharmacists (HOME study)
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OBJECTIVE: To evaluate the effectiveness of a community pharmacist-based home blood pressure (BP) monitoring program.
DESIGN: Trial of a high-intensity (HI) versus low-intensity (LI) intervention randomized in 12 community pharmacies. The HI intervention comprised 4 face-to-face visits with a trained pharmacist. Pharmacists provided patient-specific education about hypertension. Following the first and third visits, patients were provided with a home BP monitoring device and instructed to measure their BP at least once daily for the next month. Home BP readings were used by the pharmacists to develop treatment recommendations for the patient’s physician. Recommendations were discussed with the physician and, if approved, implemented by the pharmacist. In the LI intervention, pharmacists measured patients BP in the pharmacy and referred them to their physician for evaluation.
PARTICIPANTS: Patients with uncontrolled BP at baseline.
MEASUREMENTS: The main outcomes were the differences in systolic and diastolic BP (SBP and DBP) from baseline to follow-up between the HI and LI patients.
RESULTS: The study enrolled 125 patients, 64 in the HI and 61 in the LI group. From baseline, SBP declined 13.4 mmHg in the HI group and 9.0 mmHg in the LI group. At the final visit, the difference in SBP/DBP change between the HI and LI group was −4.5/−3.2 mmHg (P=.12 for SBP and P=.03 for DBP).
CONCLUSIONS: The HI intervention achieved a lower DBP and this model could be a strategy for patients with hypertension.
- Fields LE, Burt VL, Cutler JA, Hughes J, Roccella EJ, Sorlie P. The burden of adult hypertension in the United States 1999 to 2000: a rising tide. Hypertension. 2004;44:398–404. CrossRef
- Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42:1206–52. CrossRef
- American Heart Association. Heart Disease and Stroke Statistics—2004 Update. Dallas, TX: American Heart Association; 2003.
- Hajjar I, Kotchen TA. Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988–2000. JAMA. 2003;290:199–206. CrossRef
- Cabana MD, Rand CS, Powe NR, et al. Why don’t physicians follow clinical practice guidelines? A framework for improvement. JAMA. 1999;282:1458–65. CrossRef
- Oliveria SA, Lapuerta P, McCarthy BD, L’Italien GJ, Berlowitz DR, Asch SM. Physician-related barriers to the effective management of uncontrolled hypertension. Arch Intern Med. 2002;162:413–20. CrossRef
- Jones DW, Appel LJ, Sheps SG, Rocella EJ, Lenfant C. Measuring blood pressure accurately: new and persistent challenges. JAMA. 2003;289:1027–30. CrossRef
- O’Brien E, Beevers G, Lip GY. ABC of hypertension: blood pressure measurement. Part IV-automated sphygmomanometry: self blood pressure measurement. BMJ. 2001;322:1167–70. CrossRef
- Knapp KK, Paavola FG, Maine LL, Sorofman B, Politzer RM. Availability of primary care providers and pharmacists in the United States. J Am Pharm Assoc. 1999;39:127–35.
- Carter BL, Zillich AJ, Elliott WJ. How pharmacists can assist physicians with controlling blood pressure. J Clin Hypertens. 2003;5:31–7. CrossRef
- McKenney JM, Slining JM, Henderson HR, Devins D, Barr M. The effect of clinical pharmacy services on patients with essential hypertension. Circulation. 1973;48:1104–11.
- McKenney JM. Pharmacy management of hypertensive patients. J Am Pharm Assoc. 1974;14:190–5.
- Park JJ, Kelly P, Carter BL, Burgess PP. Comprehensive pharmaceutical care in the chain setting. J Am Pharm Assoc. 1996;36:443–51.
- Carter BL, Barnette DJ, Chrischilles E, Mazzotti GJ, Asali ZJ. Evaluation of hypertensive patients after care provided by community pharmacists in a rural setting. Pharmacotherapy. 1997;17:1274–85.
- U.S. Department of Health and Human Services, Public Health Service. Facts About Lowering Blood Pressure. NIH publication No. 01-3281; June 2001.
- O’Brien E, Waeber B, Parati G, Staessen J, Myers MG. Blood pressure measuring devices: recommendations of the European Society of Hypertension. BMJ. 2001;322:531–6. CrossRef
- Staessen JA, Thijs L. Development of diagnostic thresholds for automated self-measurement of blood pressure in adults. First International Consensus Conference on Blood Pressure Self-Measurement. Blood Press Monit. 2000;5:101–9. CrossRef
- The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. Arch Intern Med. 1997;157:2413-46.
- Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986;24:67–74. CrossRef
- Bobrie G, Chatellier G, Genes N, et al. Cardiovascular prognosis of “masked hypertension” detected by blood pressure self-measurement in elderly treated hypertensive patients. JAMA. 2004;291:1342–9. CrossRef
- Staessen JA, Wang JG, Thijs L. Cardiovascular prevention and blood pressure reduction: a quantitative overview updated until 1 March 2003. J Hypertens. 2003;21:1055–76. CrossRef
- MacMahon S, Peto R, Cutler J, et al. Blood pressure, stroke, and coronary heart disease. Part 1, Prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias. Lancet. 1990;335:765–74. CrossRef
- Hypertension outcomes through blood pressure monitoring and evaluation by pharmacists (HOME study)
Journal of General Internal Medicine
Volume 20, Issue 12 , pp 1091-1096
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- pharmaceutical care
- community-based intervention
- Industry Sectors
- Author Affiliations
- 1. Department of Pharmacy Practice, Purdue University School of Pharmacy, W. Lafayette, IN, USA
- 2. Health Services Research and Development, Roudebush VA Medical Center, Indianapolis, IN, USA
- 4. Division of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA
- 5. Outcomes Pharmaceutical Health Care, Des Moines, IA, USA
- 6. Division of Clinical and Administrative Pharmacy, College of Pharmacy, Iowa City, IA, USA
- 7. Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USA