Pharmacist collaborative care program with supplementary prescribing authority for hypertensive patients in primary health care

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Abstract
To evaluate the clinical outcomes of supplementary prescribing by pharmacist in reducing blood pressure versus other models of care in patients who recently received medical diagnosis of hypertension. A 24-month pragmatic controlled trial was performed with 225 patients divided into three groups: control 1 (medical centered care), control 2 (pharmacist collaborative care without supplementary prescribing authority) and intervention (pharmacist collaborative care with supplementary prescribing authority). A comparison of values was performed at basal and after 24-months of follow up in each group and differences between groups. We applied the chi-square test, student's t-test for independent samples, one-way anova whenever appropriate. A p value < 0.05 was considered statistically significant. Significant reduction in sbp and dbp was verified in every groups; intervention group showed a significantly higher reduction in the mean blood pressure levels versus control 2 (δ vs. Control 2 group = -14.3 [ci95 % -12.6 to -15.9 mmhg] p = 0.006; δ vs. Control 1 group = -17.8 [ci95 % -13.8 to -19.8 mmhg] p < 0.001) and dbp (δ vs. Control 2 group = -8.9 [ci95 % -7.7 to -10.9 mmhg] p = 0.005; δ vs. Control 1 group = -9.8 [ci95 % -7.7 to -11.5 mmhg] p < 0.001). Intervention group also showed significantly higher reduction in ldl-cholesterol and total cholesterol, versus other groups. Pharmacist collaborative care with supplementary prescribing authority provided better results in the management of blood pressure, ldl-cholesterol and total cholesterol versus other models of care.

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