| Pharmacist-physician comanagement of hypertension and reduction in 24-hour ambulatory blood pressures. | |
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MedLine Citation:
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PMID: 20937921 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Pharmacist-physician comanagement of hypertension has been shown to improve office blood pressures (BPs). We sought to describe the effect of such a model on 24-hour ambulatory BPs. METHODS: We performed a prospective, cluster-randomized, controlled clinical trial, enrolling 179 patients with uncontrolled hypertension from 5 primary care clinics in Iowa City, Iowa. Patients were randomized by clinic to receive pharmacist-physician collaborative management of hypertension (intervention) or usual care (control) for a 9-month period. In the intervention group, pharmacists helped patients to identify barriers to BP control, counseled on lifestyle and dietary modifications, and adjusted antihypertensive therapy in collaboration with the patients' primary care providers. Patients were seen by pharmacists a minimum of every 2 months. Ambulatory BP was measured at baseline and at study end. RESULTS: Baseline and end-of-study ambulatory BP profiles were evaluated for 175 patients. Mean (SD) ambulatory systolic BPs (SBPs), reported in millimeters of mercury, were reduced more in the intervention group than in the control group: daytime change in (Δ) SBP, 15.2 (11.5) vs 5.5 (13.5) (P < .001); nighttime ΔSBP, 12.2 (14.8) vs 3.4 (13.3) (P < .001); and 24-hour ΔSBP, 14.1 (11.3) vs 5.5 (12.5) (P < .001). More patients in the intervention group than in the control group had their BP controlled at the end of the study (75.0% vs 50.7%) (P < .001), as defined by overall 24-hour ambulatory BP monitoring. CONCLUSION: Pharmacist-physician collaborative management of hypertension achieved consistent and significantly greater reduction in 24-hour BP and a high rate of BP control. Trial Registration clinicaltrials.gov Identifier: NCT00201045. |
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Authors:
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Cynthia A Weber; Michael E Ernst; Genesis S Sezate; Shimin Zheng; Barry L Carter |
Publication Detail:
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Type: Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Archives of internal medicine Volume: 170 ISSN: 1538-3679 ISO Abbreviation: Arch. Intern. Med. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-10-12 Completed Date: 2010-11-15 Revised Date: 2012-05-07 |
Medline Journal Info:
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Nlm Unique ID: 0372440 Medline TA: Arch Intern Med Country: United States |
Other Details:
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Languages: eng Pagination: 1634-9 Citation Subset: AIM; IM |
Affiliation:
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Department of Pharmacy Practice and Science, The University of Iowa, Iowa City, 52242, USA. |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00201045 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Antihypertensive Agents
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therapeutic use* Blood Pressure / drug effects* Blood Pressure Monitoring, Ambulatory* Circadian Rhythm* Female Humans Hypertension / drug therapy* Interdisciplinary Communication* Iowa Male Middle Aged Pharmacists* Physicians* Prospective Studies Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
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1 R01 HL069801-01A1/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Antihypertensive Agents |
| Comments/Corrections | |
Comment In:
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Ann Intern Med. 2011 Feb 15;154(4):JC2-9
[PMID:
21320936
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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