Collaborative Management of Hypertension

描述（由申请人提供）：目前只有27%的美国人血压得到控制。首席研究员的长期目标是发展和评估医师和药剂师之间的合作关系，以改善药物治疗。本提案的目的是测试是否可以通过医师教育和医师/药剂师合作团队的发展提供的反馈来改善血压控制。这一建议的基本原理源于研究表明，医生的知识；通过与临床药师的合作，可以提高处方质量和治疗目标的实现。先前的研究存在样本量和对照不足的问题，并且没有包括结构化干预。本研究将通过在5个诊所（2个干预和3个对照）进行一项随机的前瞻性研究，与27名医生一起治疗180名血压不受控制的患者，来解决这些知识空白。有组织的干预将包括临床药剂师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、4、6、8和9个月时观察，在此期间将进行随机的零血压测量。本研究的具体目的是：1)确定与常规护理相比，利用医师教育和反馈的医师药师团队是否可以实现更好的血压控制；2)确定当医生/药剂师团队参与时，血压控制的改善是否与医生对血压指南的知识和遵守的增加有关；3)确定血压控制的变化是否与医师/药剂师关系的水平和范围有关。该模型采用一种创新的系统方法来改善血压控制。这种干预有可能在血压控制方面取得显著改善。这种模式可以成为帮助实现2010年健康人血压目标的另一种策略。

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.