Evaluating the effects of a pharmacist-led intervention program on blood pressure control within an employer sponsored healthcare clinic

Introduction: National goals regarding blood pressure control are not being met with only 44% of patients controlled on their current antihypertensive therapy. Those at greatest risk for remaining uncontrolled include men, those less than 40 years old, and Hispanics. These key demographics comprise much of the workforce at the Stemilt Clinic. A pharmacist at the Stemilt Clinic can serve as a key ally in guiding both patients and providers to improve blood pressure control in this primary care clinic.

Objectives: To evaluate the impact of a pharmacist-led intervention on blood pressure control by month three versus conventional physician follow-up. 

Study Design: Single center, randomized, prospective cohort.

Methods: The study was approved by the Institutional Review Board. Non-pregnant adults prescribed at least one antihypertensive were eligible for enrollment. After informed consent was obtained, patients were randomized to monthly pharmacist follow-up or standard of care. At each pharmacist follow-up, standardized education was provided and adherence was assessed to address barriers. Clinic nurses evaluated blood pressure at baseline and with each scheduled follow-up using a scope and cuff. Adherence was calculated utilizing a manual proportion of days covered (PDC) calculation, with adherence defined as greater than 80% based on national standards. Descriptive statistics were used to assess baseline data. Anticipated completion date is June 1^st, 2016.

Results: Baseline data demonstrates a mean blood pressure of 142/88 mmHg (137-149/82-91 mmHg 95% CI) in this clinic population. Approximately 43% of these patients are controlled on their current therapy, on par with national statistics. Approximately 15.7% of these patients are on beta-blockers, a non-preferred agent per Joint National Committee (JNC) 8 guidelines and area for potential intervention.

Conclusions: The results of this study will help demonstrate the utility of pharmacists as a resource in improving blood pressure control in a primary care clinic.