Document Detail


Physician-pharmacist cooperation program for blood pressure control in patients with hypertension: a randomized-controlled trial.
MedLine Citation:
PMID:  20616786     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim of the trial was to evaluate the effectiveness of a program of cooperation between physician and pharmacist to reduce cardiovascular risk factors in patients with mild to moderate hypertension by promoting better blood pressure (BP) control, appropriate changes in antihypertensive medications, and beneficial changes in lifestyle.
METHODS: The 132 subjects in this randomized, controlled trial were in the age range of 40-79 years. The inclusion criteria were: systolic BP (SBP) ranging from 140-179 mm Hg and/or diastolic BP (DBP) ranging from 90-99 mm Hg and treatment-naive (untreated for hypertension); or on a regimen of medication for hypertension. Of these 132 subjects, 124 (94%) were already receiving treatment with antihypertensive medications. Equal numbers of subjects were randomly assigned to one of two groups: a physician-pharmacist intervention group (n = 66) and a control group (n = 66).
RESULTS: The 6-month follow-up rate was 97% in both groups. At 6 months, the mean decrease in SBP/DBP, as measured at home in the morning, was 2.9/3.3 mm Hg in the intervention group relative to baseline (P = 0.02 and P < 0.0001 for SBP and DBP, respectively). The mean decrease in home morning SBP in the intervention group was not significantly greater than in the control group. However, the DBP decline was significantly greater in the intervention than control groups, which showed a mean decrease of 2.8 mm Hg (confidence interval: -5.5 to -0.1; P = 0.04). The percentage of patients in whom control of home morning BP was achieved was 53% in the intervention group and 47% in the control group (P = 0.40). A higher percentage of patients in the intervention group, relative to the control group, were able to reduce the use of antihypertensive medications (31 vs. 8%, P < 0.0001), and fewer patients in this group required additional medications or increases in dosage relative to the controls (11 vs. 28%, P = 0.03). Patients of the intervention group were more likely to show reduction in body mass index and sodium intake and to stop smoking, as compared with the control group.
CONCLUSIONS: A program of cooperation between physician and pharmacist was successful in reducing cardiovascular risk factors in patients with mild to moderate hypertension by promoting better blood pressure (BP) control, appropriate changes in antihypertensive medications, and beneficial changes in lifestyle.
Authors:
Hiroko Tobari; Takanori Arimoto; Nobutake Shimojo; Kiyomi Yuhara; Hiroyuki Noda; Kazumasa Yamagishi; Hiroyasu Iso
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2010-07-08
Journal Detail:
Title:  American journal of hypertension     Volume:  23     ISSN:  1941-7225     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-20     Completed Date:  2011-01-07     Revised Date:  2011-06-30    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1144-52     Citation Subset:  IM    
Affiliation:
Department of Public Health Medicine, Institute of Community Medicine, University of Tsukuba, Japan. h-tobari@umin.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antihypertensive Agents / therapeutic use
Blood Pressure / physiology
Counseling
Female
Follow-Up Studies
Humans
Hypertension / drug therapy*
Japan
Life Style
Male
Middle Aged
Patient Care Team
Patient Selection
Pharmacists*
Physicians*
Risk Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antihypertensive Agents
Comments/Corrections
Comment In:
Am J Hypertens. 2011 Jan;24(1):2-3; author reply 4   [PMID:  21164488 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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