A novel payer-provider collaboration to improve hypertension control in the community pharmacy setting [abstract]
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Objective: The objective of this quality improvement pilot was to improve hypertension monitoring and management among members of a Midwestern health plan through an innovative community pharmacy partnership supported by a validated and interoperable blood pressure (BP) monitoring technology. Methods: Health plan members with a hypertension diagnosis and attributed to a regional community pharmacy chain based on prescription claims were invited by letter and face-to-face offer from pharmacists to participate in this service. Interested patients enrolled in the program at their participating pharmacy and were assigned a “smart card” for use with an in-pharmacy BP kiosk. Use of the card links patient readings directly with their electronic pharmacy record and with an online patient portal. Patients were encouraged to monitor their BP frequently. Pharmacists intervened with patients and prescribers as necessary to address adherence issues and to adjust therapy to reach BP goals. Before and after BP readings were assessed to determine the effect of patient self-monitoring and pharmacist intervention. Results: Fifty-six of 270 eligible patients (20.7%) were enrolled in the program. Of these, 45 (80.3%) monitored their BP multiple times throughout the pilot. Fourteen patients qualified for a pre- and post-assessment as defined as having uncontrolled BP on initial reading and multiple readings throughout the pilot. Of these, patients demonstrated a mean reduction in systolic BP of 11.2 mm Hg and diastolic BP of 8 mm Hg. Nine of 16 eligible pharmacy locations enrolled patients at their sites. Participating pharmacy locations enrolled a median of 3 patients (range: 1e22). Pharmacists documented tasks completed within consults, including communicating with prescribers, educating on adherence, and recommending therapy adjustment. Conclusions: The pilot demonstrated promising early results in a model that has potential to improve hypertension monitoring and management in a community pharmacy setting. Opportunities to increase patient and pharmacist engagement should be evaluated.