Team Management of High Blood Pressure
Condition: Hypertension
MeSH terms: Hypertension
Study type: Interventional

Summary: 
      The purpose of this study is to test whether blood pressure control can be improved by
      physician education and feedback provided through the development of physician/pharmacist
      collaborative teams.
    

Detailed description: 
      BACKGROUND:

      The Healthy People 2010 target calls for controlled BP in 50% of the 50 million Americans
      with hypertension. BP is currently controlled in only 27% of the population. These population
      figures are in contrast to data from clinical trials (efficacy) in which BP has been
      controlled in 70 to 80% of study participants. Poor BP control exists in spite of six sets of
      guidelines generated over the last 30 years in the United States. While there are many causes
      for poor control, several studies have found that physicians are frequently satisfied with
      uncontrolled BPs. Numerous strategies exist to assist physicians with achieving better BP
      control, but a consistent, effective approach to solving the problem has not been found.

      DESIGN NARRATIVE:

      The objective of this study is to test whether BP 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
      physicians 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 5
      clinics (2 intervention and 3 control) with 27 physicians who care for 180 patients with
      uncontrolled BP. The structured intervention will involve clinical pharmacists who evaluate
      BP therapy and treatment strategies and make specific recommendations to the physician.
      Patients will be seen at baseline and at 2, 4, 6, 8, and 9 months, at which time random zero
      BP measurements will be performed. The specific aims of this study are (1) to determine if
      better BP 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 BP control are related to an increase in physician knowledge of and adherence
      to BP guidelines when they are involved in physician/pharmacist teams, and (3) to determine
      if changes in BP control are associated with the level and scope of the physician/pharmacist
      relationships. This model utilizes an innovative system approach to improve BP control. This
      intervention has the potential to achieve marked improvements in BP control. This model could
      become one additional strategy to help achieve the BP goals for Healthy People 2010.
    

Intervention name(s): Physician/Pharmacist Collaborative Teams
Intervention type(s): Other
Intervention description(s): The patient's physician collaborates with a clinical pharmacist to improve management of hypertension
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Hypertension management; Pharmacist management; Physician pharmacist collaboration; Blood pressure control