Pharmacoeconomic Evaluation of a Pharmacist-Managed Hypertension Clinic
Pharmacoeconomic Evaluation of a Pharmacist-Managed Hypertension Clinic
Study Objective. To measure clinical, economic, and humanistic outcomes associated with a pharmacist-managed hypertension clinic compared with physician-managed clinics.
Design. Prospective, randomized, comparative study.
Setting. Managed care organization.
Patients. A total of 330 patients with mild-to-moderate essential hypertension.
Intervention. Hypertension care provided by either the pharmacist-managed hypertension clinic or physician-managed general medical clinics.
Measurements and Main Results. Baseline and 6-month evaluations consisted of systolic and diastolic blood pressure measurements, a short-form health survey, and collection of health care utilization information. After treatment, blood pressure measurements were significantly lower (p<0.001) in the pharmacist-managed hypertension clinic group than in the physician-managed clinic group. Patient satisfaction was significantly higher in the hypertension clinic group. Total costs for the hypertension clinic group were not different from those of the physician-managed clinic group ($242.46 vs $233.20, p=0.71), but cost:effectiveness ratios were lower in the hypertension clinic group ($27 vs $193/mm Hg for systolic blood pressure readings, and $48 vs $151/mm Hg for diastolic blood pressure readings).
Conclusion. In a hypertension clinic, pharmacists can be a cost-effective alternative to physicians in management of patients, and they can improve clinical outcomes and patient satisfaction.
Clinical pharmacists are an integral part of the health care system and seek to improve quality of pharmaceutical care by providing supportive services to health professionals and patients alike. Pharmacists have made significant contributions to improved patient care in primary care clinics and in other clinical settings as well.
Pharmacists have extensive knowledge about drugs regarding their therapeutic administration, cost, and adverse effects and can help physicians choose appropriate drugs while maximizing clinical benefits and reducing the number of negative outcomes. Hypertension is one area in which pharmacists have demonstrated a positive impact in helping physicians regulate drug therapy. Several studies have documented the beneficial effect a pharmacist can have in a clinic: reducing drug costs while improving blood pressure control; minimizing potential drug interactions, hospitalizations, and emergency room visits; and improving patient perception of quality of health care provided.
According to the National Education Program Working Group report on management of patients with hypertension and high blood cholesterol, hypertension can be satisfactorily controlled in virtually all patients. The report states that the focal point should not be whether high blood pressure can be reduced, but whether it can be reduced at a reasonable cost with minimal adverse effects. Some studies have evaluated costs associated with treatment of hypertension; others have evaluated quality of life in patients with hypertension. However, little data exist on the cost-effectiveness of a clinical pharmacist assisting in the management of patients with hypertension and how this affects patients' perceived satisfaction with their health care.
Study Objective. To measure clinical, economic, and humanistic outcomes associated with a pharmacist-managed hypertension clinic compared with physician-managed clinics.
Design. Prospective, randomized, comparative study.
Setting. Managed care organization.
Patients. A total of 330 patients with mild-to-moderate essential hypertension.
Intervention. Hypertension care provided by either the pharmacist-managed hypertension clinic or physician-managed general medical clinics.
Measurements and Main Results. Baseline and 6-month evaluations consisted of systolic and diastolic blood pressure measurements, a short-form health survey, and collection of health care utilization information. After treatment, blood pressure measurements were significantly lower (p<0.001) in the pharmacist-managed hypertension clinic group than in the physician-managed clinic group. Patient satisfaction was significantly higher in the hypertension clinic group. Total costs for the hypertension clinic group were not different from those of the physician-managed clinic group ($242.46 vs $233.20, p=0.71), but cost:effectiveness ratios were lower in the hypertension clinic group ($27 vs $193/mm Hg for systolic blood pressure readings, and $48 vs $151/mm Hg for diastolic blood pressure readings).
Conclusion. In a hypertension clinic, pharmacists can be a cost-effective alternative to physicians in management of patients, and they can improve clinical outcomes and patient satisfaction.
Clinical pharmacists are an integral part of the health care system and seek to improve quality of pharmaceutical care by providing supportive services to health professionals and patients alike. Pharmacists have made significant contributions to improved patient care in primary care clinics and in other clinical settings as well.
Pharmacists have extensive knowledge about drugs regarding their therapeutic administration, cost, and adverse effects and can help physicians choose appropriate drugs while maximizing clinical benefits and reducing the number of negative outcomes. Hypertension is one area in which pharmacists have demonstrated a positive impact in helping physicians regulate drug therapy. Several studies have documented the beneficial effect a pharmacist can have in a clinic: reducing drug costs while improving blood pressure control; minimizing potential drug interactions, hospitalizations, and emergency room visits; and improving patient perception of quality of health care provided.
According to the National Education Program Working Group report on management of patients with hypertension and high blood cholesterol, hypertension can be satisfactorily controlled in virtually all patients. The report states that the focal point should not be whether high blood pressure can be reduced, but whether it can be reduced at a reasonable cost with minimal adverse effects. Some studies have evaluated costs associated with treatment of hypertension; others have evaluated quality of life in patients with hypertension. However, little data exist on the cost-effectiveness of a clinical pharmacist assisting in the management of patients with hypertension and how this affects patients' perceived satisfaction with their health care.