INNOVATIONS in Pharmacy (Jan 2015)

An Advanced Registered Nurse Practitioner-Community Pharmacist Team-Based Approach to Managing Hypertension in a Rural Community Pharmacy

  • Christopher P. Parker,
  • Sherry L. Kelchen,
  • William R. Doucette

DOI
https://doi.org/10.24926/iip.v6i2.384
Journal volume & issue
Vol. 6, no. 2

Abstract

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Purpose: To evaluate the implementation of an Advanced Registered Nurse Practitioner (ARNP) – community pharmacist team-based collaborative model for managing hypertension in a rural, Midwestern, community pharmacy and family medicine clinic using the core functions of the patient centered medical home model (PCMH). Methods: Thirteen patients with uncontrolled hypertension, 5 of who were newly diagnosed, were referred to the pharmacist by the ARNP. The pharmacist rechecked the patient’s blood pressure (BP) every 2 weeks after referral and made drug therapy change recommendations to the ARNP if the patient was not below goal. Results: Following the intervention, the average SBP and DBP decreased 24 mmHg and 12mmHg, respectively. The pharmacists made 21 recommendations (dose increase (11), add a medication (6), change a medication (2), and addition of an adherence tool (2)), 100% of which were accepted by the ARNP. Conclusion: A team-based approach to managing hypertension in a rural community pharmacy and family medicine clinic was an effective way to lower blood pressure. In addition, the core functions of the PCMH model can be delivered in a small family medicine practice. Creating specific expectations for each member of the team prior to referring patients improved the efficiency of the intervention. Type: Original Research

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