Collaborative Management of Hypertension

点击翻译按钮获取中文摘要

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.