Pharmacist-Guided Home Blood Pressure Monitoring May Help Patients

Study found combination led to better control of hypertension

By Serena Gordon

HealthDay Reporter

TUESDAY, July 2 (HealthDay News) -- Using home blood pressure monitoring and partnering with a pharmacist for lifestyle advice and medication changes led to better control of hypertension, a new study shows.

After six months of the intervention, nearly 72 percent of the study volunteers had their high blood pressure under control compared to 45 percent in the group that received usual care. Also, the effects of the intervention persisted even after the intervention ended. Six months later, about 72 percent of the intervention group had their high blood pressure under control compared to 57 percent in the usual care group.

"The reason that only about half of people with [high] blood pressure have it under control is that usual care isn't working. We combined two interventions that we thought would be very powerful together -- home monitoring and pharmacist managements -- and this is one system that we've shown works very well for blood pressure control," said senior investigator Dr. Karen Margolis, from the HealthPartners Institute for Education and Research in Minneapolis.

The findings appear in the July 3 issue of the Journal of the American Medical Association.

High blood pressure affects about 30 percent of U.S. adults, according to background information in the study. Treating and controlling high blood pressure can help prevent cardiovascular events, such as heart attacks. However, only about half of the adults in the United States with high blood pressure have it under control.

Home blood pressure monitoring has shown some success in helping people lower their blood pressure, so the researchers took that a step further and used telemonitoring devices that could send blood pressure readings to a pharmacist who could then adjust that person's blood pressure medication accordingly.

The study included 450 people receiving care at one of eight different clinics. All of the people recruited for the study had high blood pressure that wasn't well controlled.

The patients were randomized to receive either usual care (222 people) or the study intervention, which included blood pressure telemonitoring with pharmacist management.

In the study intervention group, each person received a home blood pressure monitor capable of sending readings to a secure website that a pharmacist monitored. At the start of the study, patients met with the pharmacist for an hour and were taught how to use the machines. They were also given lifestyle advice on lowering their blood pressure.

People in the study intervention group were asked to send at least six blood pressure readings from different times of the day to the pharmacist each week. During the first six months of the study, patients and pharmacists talked by phone every two weeks, until blood pressure was under control for at least six weeks, and then they talked monthly. During months seven to 12 of the study, the calls were reduced to every two months. During the calls, pharmacists reviewed lifestyle changes and emphasized adherence to medications.

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