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document
Physician-pharmacist cooperation program for blood pressure control in patients with hypertension : a randomized-controlled trial . BACKGROUND The aim of the trial was to evaluate the effectiveness of a program of cooperation between physician and pharmacist to reduce cardiovascular risk factors in patients with mild to moderate hypertension by promoting better blood pressure ( BP ) control , appropriate changes in antihypertensive medications , and beneficial changes in lifestyle . METHODS The 132 subjects in this randomized , controlled trial were in the age range of 40-79 years . The inclusion criteria were : systolic BP ( SBP ) ranging from 140-179 mm Hg and/or diastolic BP ( DBP ) ranging from 90-99 mm Hg and treatment-naive ( untreated for hypertension ) ; or on a regimen of medication for hypertension . Of these 132 subjects , 124 ( 94 % ) were already receiving treatment with antihypertensive medications . Equal numbers of subjects were randomly assigned to one of two groups : a physician-pharmacist intervention group ( n = 66 ) and a control group ( n = 66 ) . RESULTS The 6-month follow-up rate was 97 % in both groups . At 6 months , the mean decrease in SBP/DBP , as measured at home in the morning , was 2.9/3.3 mm Hg in the intervention group relative to baseline ( P = 0.02 and P < 0.0001 for SBP and DBP , respectively ) . The mean decrease in home morning SBP in the intervention group was not significantly greater than in the control group . However , the DBP decline was significantly greater in the intervention than control groups , which showed a mean decrease of 2.8 mm Hg ( confidence interval : -5.5 to -0.1 ; P = 0.04 ) . The percentage of patients in whom control of home morning BP was achieved was 53 % in the intervention group and 47 % in the control group ( P = 0.40 ) . A higher percentage of patients in the intervention group , relative to the control group , were able to reduce the use of antihypertensive medications ( 31 vs. 8 % , P < 0.0001 ) , and fewer patients in this group required additional medications or increases in dosage relative to the controls ( 11 vs. 28 % , P = 0.03 ) . Patients of the intervention group were more likely to show reduction in body mass index and sodium intake and to stop smoking , as compared with the control group . CONCLUSIONS A program of cooperation between physician and pharmacist was successful in reducing cardiovascular risk factors in patients with mild to moderate hypertension by promoting better blood pressure ( BP ) control , appropriate changes in antihypertensive medications , and beneficial changes in lifestyle .
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Intervention_Educational
Physician-pharmacist cooperation program
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Intervention_Educational
cooperation between physician and pharmacist
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Intervention_Educational
physician-pharmacist intervention group
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Intervention_Control
control group
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Outcome_Physical
systolic BP ( SBP )
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Outcome_Physical
diastolic BP ( DBP )
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Outcome_Physical
SBP/DBP
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Outcome_Physical
home morning SBP
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Outcome_Physical
DBP
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Outcome_Physical
home morning BP
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Outcome_Other
use of antihypertensive medications
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Outcome_Physical
additional medications
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Outcome_Physical
body mass index
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Outcome_Mental
sodium intake
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Outcome_Mental
stop smoking
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Participant_Condition
hypertension
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Participant_Condition
mild to moderate hypertension
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Participant_Sample-size
132
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Participant_Age
40-79 years
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Participant_Condition
systolic BP ( SBP ) ranging from 140-179 mm Hg
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Participant_Condition
diastolic BP ( DBP ) ranging from 90-99 mm Hg
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Participant_Condition
hypertension
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Participant_Sample-size
132
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Participant_Sample-size
124
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Participant_Condition
antihypertensive medications
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Participant_Condition
mild to moderate hypertension