Pharmacist-physician collaborative care model vs. standard care: Assessing time to blood pressure goal

Introduction: Pharmacist-­physician collaborative care models (PCCMs) are shown to improve BP control rates and reduce mean BP, but it is unknown if PCCMs affect time to BP goal.

Objectives: The primary objective is to compare the time to BP control of a PCCM to standard care (SC) in an indigent population. Secondary objectives include the proportion of patients with BP control at the end of the 12-month follow-up period and any factors that may affect time to BP control.

Study Design: This retrospective cohort study utilizes paper and electronic medical records.

Methods: New patients first seen in clinic between January 1, 2012 and December 31, 2013 with a documented diagnosis of hypertension (or taking antihypertensive medication at the initial visit) were included. Exclusion criteria consists of eGFR <30ml/min, <2 BP readings, and pregnancy. A Virginia safety-net free clinic serves as the PCCM site and a Virginia health system providing primary care to patient-assistance program recipients serves as the SC site. Time to BP control is defined as the time from the initial clinic visit to the first visit with a BP <140/90. The proportion of patients at goal was determined by evaluating the last BP measurement obtained during the 12-month follow-up period. The median (IQR) time to goal for each group was calculated and descriptive statistics used for patient demographics.

Results: Interim results for the 350 eligible PCCM patients show the median time to BP control was 21 days (IQR 15-28) requiring a mean of 2.6 visits. At 12-months, 61% of PCCM patients were at goal. The remaining data collection and analysis for the SC group is expected to be complete by April 2016.

Conclusions: These preliminary findings suggest that the early and intensive follow-up provided by the PCCM quickly gets patients with hypertension to their goal BP.