Collaborative Management of Hypertension

描述(由申请人提供)：目前只有27%的美国人的血压得到了控制。首席研究员的长期目标是发展和评估医生和药剂师之间的合作关系，以改善药物治疗。这项建议的目的是测试是否可以通过医生教育和通过发展医生/药剂师协作团队提供的反馈来改善血压控制。这一建议的理由来自于研究表明，当医生与临床药剂师合作时，医生的知识、处方质量和治疗目标的实现都可以得到改善。以前的研究存在样本量和对照不足的问题，也没有包括结构性干预。这项研究将通过在五个诊所(两个干预和三个对照)进行一项随机的前瞻性研究来解决这些知识差距，包括27名医生，他们照顾180名血压不受控制的患者。有组织的干预将包括临床药剂师，他们评估血压治疗和治疗策略，并向医生提出具体建议。患者将在基线、2个月、4个月、6个月、8个月和9个月进行随机零血压测量。这项研究的具体目的是：1)确定是否可以通过使用医生药剂师团队来实现更好的血压控制，这些团队利用医生的教育和反馈，而不是通常的护理；2)确定血压控制的改善是否与医生在医生/药剂师团队中参与时增加对血压指南的了解和遵守有关；3)确定血压控制的变化是否与医生/药剂师关系的水平和范围有关。该模型采用了一种创新的系统方法来改进血压控制。这种干预措施有可能在血压控制方面实现显著改善。这一模式可能成为帮助实现2010年健康人血压目标的另一种战略。

DESCRIPTION (provided by applicant): Blood pressure is currently controlled in only 27percent of the U.S. population. The long-range goal of the principal investigator is to develop and evaluate collaborative relationships between physicians and pharmacists that improve pharmacotherapy. The objective of this proposal is to test whether blood pressure control can be improved by physician education and feedback provided through the development of physician/pharmacist collaborative teams. The rationale for this proposal is generated from studies demonstrating that physician knowledge; quality of prescribing and attainment of treatment goals can be improved when they collaborate with clinical pharmacists. Previous studies have suffered from insufficient sample size and controls and did not include a structured intervention. This study will address these gaps in knowledge by conducting a randomized, prospective study in five clinics (two intervention and three control) with 27 physicians who care for 180 patients with uncontrolled blood pressure. The structured intervention will involve clinical pharmacists who evaluate blood pressure therapy and treatment strategies and make specific recommendations to the physician. Patients will be seen at baseline, 2, 4, 6, 8 and 9 months at which time random zero blood pressure measurements will be performed. The specific aims of this study are: 1) to determine if better blood pressure control can be achieved by the use of physician pharmacist teams that utilize physician education and feedback when compared to usual care, 2) to determine if improvements in blood pressure control are related to an increase in physician knowledge of, and adherence to, blood pressure guidelines when they are involved in physician/pharmacist teams, 3) to determine if changes in blood pressure control are associated with the level and scope of the physician/pharmacist relationships. This model utilizes an innovative system approach to improve blood pressure control. This intervention has the potential to achieve marked improvements in blood pressure control. This model could become one additional strategy to help achieve the blood pressure goals for Healthy People 2010.