Pharmacist-physician collaboration improves blood pressure control

OBJECTIVE: To evaluate the effect of teamwork (physician and pharmacist) on the management of uncontrolled hypertensive patients.

METHODS: This is a randomized controlled clinical trial conducted from March to November 2009. Patients attending the Family Medicine Clinic at Jordan University Hospital, Amman, Jordan with uncontrolled hypertension were invited to participate in the study. A total of 253 patients were randomly allocated to an intervention (n=130) or control group. In the intervention group, patients were managed by a physician-pharmacist team. In the control group, patients were managed by physician(s) only.

RESULTS: In the intervention group, 79.4% of patients achieved blood pressure (BP) goals specified by the Joint National Committee on Prevention and Management, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VII) compared to 65.6% in the control group (p=0.01). Decline in systolic BP was 16.1 +/- 14.6 mm Hg in the intervention group, and 10.6 +/- 13.5 mm Hg in the control group (p=0.002). Reduction in diastolic BP was 10.5 +/- 12.9 mm Hg in the intervention group, and 7.17 +/- 13.11 mm Hg in the control group, (p=0.04). Data were presented as mean +/- standard deviation.

CONCLUSION: This study found that the physician-pharmacist collaborative approach to uncontrolled hypertension in Jordan improved the rate of BP control in hypertensive patients, and resulted in more profound decline in both systolic and diastolic BP, and this will probably reflect on better outcomes in cardiovascular diseases. Establishing pharmaceutical care managed clinic in the setting of outpatient-clinics is possible, and provides better management of patients.