Centralized outreach with embedded pharmacist e-consultation to reduce therapeutic inertia and improve blood pressure control.

Abstract

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Purpose: To evaluate the impact of a population health intervention to reduce therapeutic inertia and improve hypertension control in a multipractice primary care setting.

Methods: This retrospective cohort study compares clinical and process outcomes in an intervention cohort versus a parallel comparator cohort of patients in nonintervention clinics. Centralized outreach coordinators identified patients with systolic blood pressure (BP) of >150 mm Hg, called each patient, scheduled a hypertension-focused visit with a primary care physician (PCP), then forwarded a message to the clinic-based pharmacist, who reviewed the patient record and documented clinical recommendations for hypertension control prior to the patient visit.

Results: Outreach was performed for 426 intervention patients from July to December 2022, and outcomes were compared to those in 587 usual-care patients. A higher percentage of intervention patients attended a hypertension-focused clinic visit with their PCP (57.3% vs 38.8%, adjusted P < 0.001), had hypertensive therapy addressed at that visit when their BP was above 140/90 mm Hg (63.3% vs 44.2%, adjusted P = 0.010), and achieved a BP of <140/90 mm Hg (27.9% vs 16.9%, adjusted P < 0.001) within 6 months of outreach.

Conclusion: A clinic-based population health approach reduced therapeutic inertia and improved BP control in a cohort of in hypertensive patients compared with a similar cohort of patients in clinics who did not receive the intervention.