Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, Iowa 52242, USA.
Pharmacotherapy. 2010 Mar;30(3):228-35. doi: 10.1592/phco.30.3.228.
To assess blood pressure control after discontinuation of a physician-pharmacist collaborative intervention.
Comparative analysis of data of the patients who received the intervention versus a control group from a prospective, cluster-randomized, 9-month efficacy trial and the same patients' data 18 and 27 months after completion of the trial, abstracted from their medical records.
Five primary care medical offices operated by a university health system.
One hundred four patients with hypertension; 65 were in the intervention group, and 39 were in the control group.
In the prospective study, patients were randomized to receive a physician-pharmacist collaborative intervention to improve blood pressure control or to the control group. Systolic and diastolic blood pressures were measured by a research nurse at baseline and at the end of the study (9 mo later). In the current study, data were abstracted for blood pressure and blood pressure control at 18 and 27 months (9 and 18 mo, respectively, after discontinuation of the study). At baseline, mean +/- SD systolic blood pressure was 152.5 +/- 9.5 and 150.1 +/- 9.6 mm Hg in the intervention and control groups, respectively (p=0.22). At 9 months, systolic blood pressure decreased to 124.5 +/- 10.7 and 132.0 +/- 15.1 mm Hg (p=0.0038 between groups), and blood pressure was controlled in 78.5% and 48.7% (p=0.0017) of patients in the intervention and control groups, respectively. By 18 months, systolic blood pressure had deteriorated to 131.0 +/- 12.2 and 143.3 +/- 17.5 mm Hg (p<0.001), and blood pressure control rates decreased to 53.9% and 30.8% (p=0.02). By 27 months, systolic blood pressure was 131.3 +/- 13.0 and 141.2 +/- 15.8 mm Hg (p=0.0008), and blood pressure control was 55.4% and 35.9% (p=0.05).
A sustained positive effect on blood pressure control was noted up to 18 months after discontinuation of a physician-pharmacist collaborative intervention, when compared with a control group. Blood pressure control did deteriorate at a similar rate in both the intervention and control groups, but the percentage of patients with controlled blood pressure remained significantly higher in the intervention group. These results suggest that continued interventions by pharmacists may be necessary to maintain high rates of blood pressure control, especially in those patients whose blood pressure begins to increase.
评估停止医生-药剂师合作干预后血压的控制情况。
对参加前瞻性、群组随机、为期 9 个月的疗效试验的患者进行干预组与对照组的数据进行比较分析，以及对试验结束后 18 个月和 27 个月（分别为研究结束后 9 个月和 18 个月）从他们的病历中提取的相同患者的数据进行比较分析。
由大学卫生系统运营的五个初级保健医疗办公室。
104 名高血压患者；65 名患者在干预组，39 名患者在对照组。
在前瞻性研究中，患者被随机分配接受医生-药剂师合作干预以改善血压控制或对照组。研究护士在基线和研究结束时（9 个月后）测量收缩压和舒张压。在当前的研究中，数据是在 18 个月和 27 个月（分别为研究结束后 9 个月和 18 个月）时的血压和血压控制情况。基线时，干预组和对照组的平均收缩压分别为 152.5+/-9.5 和 150.1+/-9.6mmHg（p=0.22）。9 个月时，收缩压分别降至 124.5+/-10.7 和 132.0+/-15.1mmHg（组间差异 p=0.0038），干预组和对照组的血压控制率分别为 78.5%和 48.7%（p=0.0017）。18 个月时，收缩压恶化至 131.0+/-12.2 和 143.3+/-17.5mmHg（p<0.001），血压控制率下降至 53.9%和 30.8%（p=0.02）。27 个月时，收缩压分别为 131.3+/-13.0 和 141.2+/-15.8mmHg（p=0.0008），血压控制率分别为 55.4%和 35.9%（p=0.05）。
与对照组相比，停止医生-药剂师合作干预后，血压控制的持续积极影响可维持长达 18 个月。在干预组和对照组中，血压控制都以相似的速度恶化，但血压控制的患者百分比在干预组中仍然显著更高。这些结果表明，需要药剂师持续干预以维持血压控制的高比率，特别是在那些血压开始升高的患者中。
