Teaming physicians with pharmacists who counsel patients and make medication recommendations shows promise in the treatment of uncontrolled hypertension, investigators report.
In a study of 95 men and women whose blood pressure remained uncontrolled after three physician visits in the previous six months, researchers found that those who received diet and exercise counseling and medication advice from a pharmacist were more likely to achieve blood pressure control than were patients who received medical care alone.
"A team approach between physicians and pharmacists may have positive effects even in high-risk minorities in whom control of hypertension is especially difficult to achieve," Dr. Paul Bogden, of the University of Hawaii, Honolulu, and colleagues report in the November issue of the Journal of General Internal Medicine.
Forty-nine of the 95 patients were randomly assigned to meet with a pharmacist before their regular physician visit. The pharmacists counseled them on diet, exercise, and other lifestyle factors, as well as on the importance of following their prescribed medications.
Pharmacists also reviewed patients' medication regimens and made recommendations to their physicians about less expensive or better formulations. Overall, 55 percent of those who saw a consultant pharmacist achieved blood pressure control, compared with 20 percent of those who received medical care alone.
The pharmacist intervention was also shown to be effective among Hawaiians of mixed ancestry: eight of 13 mixed-ancestry patients in the intervention group achieved blood pressure control, compared with only two of 11 in the regular medical care group.
Interestingly, even patients who had no change or decrease in their blood pressure medication appeared to benefit from the pharmacist's intervention, the researchers say.
"In these patients, compliance, changes in diet, reduction in alcohol consumption, and weight reduction may have been important," the researchers say, noting that changes in these risk factors may have resulted more from the greater individual attention that the pharmacists were able to give the patients than from their pharmacological expertise.
The Journal of General Internal Medicine, a monthly peer-reviewed journal of the Society of General Internal Medicine, publishes original articles on research and education in primary care. For information about the Journal, contact: Margo Glen Alderton, (215) 823-4471. .
Posted by the Center for the Advancement of Health (http://www.cfah.org). For information about the Center, contact Richard Hebert (rhebert@cfah.org) (202) 387-2829.
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Journal of General Internal Medicine