PHARMACISTS ABILITY TO INFLUENCE OUTCOMES OF HYPERTENSION THERAPY

We measured the impact of pharmaceutical care on outcomes of antihyper tensive therapy for patients with elevated baseline blood pressures wh o were attending an urban university-affiliated internal medicine clin ic. The intervention group received education about hypertension, drug and nondrug management, and assistance to enhance compliance. The pha rmacist made recommendations to physicians regarding pharmacotherapy. The control group received no such education, and interventions relati ng to pharmacotherapy were only physician initiated. Over an average f ollow-up of 5 months, significant decreases in mean blood pressures we re noted for the intervention group from baseline to final assessment (156.5/144.5 mm Hg systolic, p=0.001; 91.6/86.9 mm Hg diastolic, p=0.0 1), with insignificant changes in mean pressures in the control group (153.7/151.0 mm Hg systolic, p=0.48; 90.4/87.8 mm Hg diastolic, p=0.29 ). Comparing the groups, the change in diastolic pressures was insigni ficant (4.7 vs 2.6 mm Hg intervention vs control, p=0.49), but the cha nge in systolic pressure was more impressive (12.0 vs 2.7 mm Hg, respe ctively p=0.05). There was no significant difference in SF-36 Health S urvey scores between groups. A significant decrease (p=0.03) in the SF -36 physical functioning domain was seen in the intervention group, bu t no other significant changes in health-related quality of life score s. Pharmaceutical care contributed to improved blood pressure control ih these patients.