Pharmacist Intervention, Telemonitoring Helped Lower Patient BP

According to a recent study published online in JAMA Network Open, an intensive home blood pressure (BP) telemonitoring and pharmacist management intervention resulted in significantly lower BP for up to 24 months.

“The results were previously reported of a trial of home blood pressure (BP) telemonitoring and pharmacist management intervention in which the interventions stopped after 12 months,” study author Karen Margolis, MD, MPH, of HealthPartners Institute for Education and Research, and colleagues wrote. “There were significantly greater reductions in systolic BP (SBP) in the intervention group than in the usual care group at 6, 12, and 18 months (−10.7, −9.7, and −6.6 mm Hg, respectively).”

The researchers sought to examine the durability of the intervention effect on BP through 54 months of follow-up and compare BP measurements. The researchers conducted a randomized clinical trial among 16 primary care clinics and 450 patients with uncontrolled hypertension in a large health system from March 2009 to November 2015. They measured changes from baseline to 54 months in in SBP and diastolic BP (DBP) measured as the mean of 3 measurements obtained at each research clinic visit. The interventions included home BP telemonitoring intervention with pharmacist’s management or usual care.

Among 450 patients, 228 were randomized to the telemonitoring intervention and 222 to usual care. The researchers obtained clinic BP measurements from 326 of the 450 study patients at the 54-month follow-up visit—including 162 randomized to the telemonitoring intervention and 164 to usual care. Further, the researchers obtained routine clinical care BP measurements from 439 of 450 study patients at 6248 visits during the follow-up period.

Based on the research clinic measurement, baseline mean SBP was 148 mm Hg in both groups. In the intervention group, mean SBP at 6-, 12-, 18-, and 54-month follow-up was 126.7, 125.7, 126.9, and 130.6 mm Hg, respectively. For patients in the usual care group, mean SBP at 6-, 12-, 18-, and 54-month follow-up was 136.9, 134.8, 133.0, and 132.6 mm Hg, respectively. The researchers noted that the differential reduction by the study group in SBP from baseline to 54 months was −2.5 mm Hg. Additionally, the DBP followed a similar pattern, with a differential reduction by study group from baseline to 54 months of −1.0 mm Hg. Overall, the researchers found that the SBP and DBP results from routine clinical measurements suggested significantly lower BP in the intervention group for up to 24 months.

“This intensive intervention had sustained effects for up to 24 months (12 months after the intervention ended),” Dr Margolis and colleagues concluded. “Long-term maintenance of BP control is likely to require continued monitoring and resumption of the intervention if BP increases.”

—Julie Gould

For more Pharmacy Learning Network articles, visit the homepage

To learn about Pharmacy Learning Network Live meetings, click here