Patient-pharmacist relationships key to home BP monitoring success

JAPhA study: Individualized treatment plans and frequent communication promote better BP management

 

Strong patient-pharmacist relationships are key to success in pharmacist-led home blood pressure monitoring interventions for patients with uncontrolled hypertension, according to research published online in the Journal of the American Pharmacists Association. In 2013, the Hyperlink trial demonstrated that a team-based approach involving pharmacists can improve blood pressure management. In the second arm of the trial, researchers dug deeper into the data and sought to understand which aspects of the intervention were most conducive to positive outcomes.

 

In the study, researchers examined data from 228 patients who participated in the intervention in the original Hyperlink trial. They also conducted five patient focus groups and four interviews with pharmacists to get both patient and pharmacist perspectives. The patients used home blood pressure telemonitors to send their readings to a study pharmacist, and the pharmacist consulted with them every 2 to 4 weeks for 6 months and then every 2 months afterward. The mean blood pressure among patients at intake was 148/85 mmHg, which declined steadily at each of three phone visits before leveling out at 123/73 mmHg at 5 months. Pharmacists adjusted medications at the intake visit and at each phone visit as necessary, with adjustments declining after the third phone visit.

 

In the focus groups, patients said it was important to have a relationship with a pharmacist and that they found it helpful to have frequent and immediate feedback from a pharmacist based on their home blood pressure readings, as opposed to waiting much longer for appointments with their physicians. Both patients and pharmacists stressed the value of individual treatment plans and the importance of frequent communication between pharmacists and patients.