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      Improving blood pressure control in a pharmacist-managed hypertension clinic.


      Aged, Antihypertensive Agents, pharmacology, therapeutic use, Blood Pressure, drug effects, physiology, Chi-Square Distribution, Hospitals, Veterans, statistics & numerical data, Humans, Hypertension, drug therapy, physiopathology, psychology, Male, Middle Aged, Outpatient Clinics, Hospital, Patient Compliance, Patient Satisfaction, Pharmacists, Pharmacy Administration, methods, Prospective Studies, Quality of Life, Statistics, Nonparametric

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          To determine whether pharmaceutical care provided by a pharmacist-managed hypertension clinic results in better treatment outcomes when compared with traditional health care from a primary care physician. Prospective, controlled study Veterans Affairs Medical Center, Philadelphia, Pennsylvania. Fifty six patients with essential hypertension; 27 were randomly assigned to the intervention group and 29 to the control group. Patients in the intervention group were scheduled monthly to meet with a clinical pharmacist who made appropriate changes in prescribed drugs, adjusted dosages, and provided drug counseling in accordance with the hypertension guidelines in the sixth report of the Joint National Committee on the Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI). Patients in the control group received standard care from their physicians. The study period was 6 months. Treatment outcomes were measured by changes in compliance, blood pressure, and patient satisfaction. The Short Form-36 health survey and a patient satisfaction survey were used to measure changes in patient satisfaction, and a compliance evaluation survey measured compliance. Twenty-one (81%) patients in the intervention group attained their blood pressure goal of below 140/90 mm Hg at the completion of the study versus only eight (30%) in the control group (p < 0.0001). Of 11 patients with diabetes in the intervention group, 10 (91%) attained their blood pressure goal (< 130/80 mm Hg) versus only two (12 %) of 16 patients with diabetes in the control group (p < 0.0001). No significant differences in patient satisfaction or compliance were reported between the intervention and control groups. Pharmaceutical care improves blood pressure control and results in more patients with hypertension reaching their blood pressure goal.

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