Pharmacist-led hypertension management in a minority patient population

Abstract

Background: Nearly half of adults in America have hypertension (HTN), and only approximately 1 in 4 adults has their blood pressure (BP) under control. High BP is more common in African Americans adults, and BP control is lower among minority adults. Pharmacist-led interventions for HTN have been shown to be effective in improving BP control and reducing the risk of cardiovascular events.

Objective: This study aimed to leverage electronic health record (EHR) data to improve BP control through pharmacist-led interventions.

Methods: This was a prospective, cohort study conducted at Atrium Health Concord Internal Medicine, a large suburban practice in Concord, North Carolina. Patients with uncontrolled HTN were identified using an EHR data tool. Patients were included if they were at least 18 years of age, had sustained uncontrolled HTN, and were of a minority race or ethnicity. The primary outcome was proportion of patients achieving a BP of < 140/90 mm Hg in the intervention group compared with a control group. Secondary outcomes included mean change in BP from baseline, number and type of visits, and number and type of interventions.

Results: A total of 110 patients were enrolled in this study, 55 patients in each cohort. The baseline characteristics were generally well balanced between the 2 groups. The mean age was 62 years, and most patients were female and African American. For the primary outcome, 70.9% of the patients in the intervention group achieved a BP of < 140/90 mm Hg compared with 32.7% of the patients in the control group (P < 0.001). The most common intervention was lifestyle modifications, followed by BP monitoring technique education and medication adherence interventions.

Conclusion: In this study, pharmacist-led interventions resulted in clinically and statistically significant improvements in sustained uncontrolled HTN among minority populations.