Controlling Blood Pressure During a Pandemic: The Impact of Telepharmacy for Primary Care Patients

Abstract

Introduction Studies have shown positive clinical outcomes in chronic conditions, such as hypertension, through pharmacist-delivered medication therapy management and medication adherence services. Given the need for social distancing during the COVID-19 pandemic, increased utilization of telepharmacy strategies has been employed for managing blood pressure control. Methods A retrospective single-center cohort study that compared in-person pharmacist visits and telepharmacy visits in primary care patients with hypertension via electronic chart review from January 2018 to July 2022. Subjects were included who were at least 18 years of age with hypertension. Comparator groups were patients who underwent an in-person pharmacy (pre-COVID-19) visit vs a telepharmacy visit (post-COVID-19). The primary outcome was the number of patients with controlled blood pressure based on a blood pressure goal of less than or equal to 130/80 following telepharmacy visit vs in-person visit. Medication adherence, pharmacist intervention, incidence of antihypertensive side-effects, and blood pressure maintenance based on a goal of ≤140/90 were also evaluated. Results A total of 77 patients were included. There was no difference in the primary outcome following in person pharmacy visits compared to telepharmacy visits ( P = .690). There was also no difference found for the secondary endpoints of blood pressure goal less than or equal to 140/90 mmHg ( P = .481), medication adherence ( P = 1.00), or antihypertensive adverse events ( P = .344). Conclusion Telepharmacy visits had a nonsignificant change in blood pressure control when compared to in-person visits. Results suggest that the utilization of either in-person or telepharmacy strategies benefit the management of hypertension.

Telephone versus In-Person Pharmacist-Led Medication Reviews in Home Dialysis Patients: Evaluating Quality of Care and Patient Satisfaction

“…Patients reported a similar quality of care with telephone medication reviews and found them to be convenient and effective. This study supports existing literature that pharmacists have a positive impact on clinical outcomes and maintain clinical services with telephone-based care, with evidence from individual studies and systematic reviews indicating this positive impact existing across clinical care disciplines and in both outpatient and inpatient settings [ 6 , 7 , 8 , 9 , 10 , 15 , 16 ].…”

“…Pharmacist recommendations were accepted more often when communicated verbally to physicians (either in-person or by phone) rather than by text through a hospital software system (+27.7%, 95% CI: +23.2 to +32.1%) [ 17 ]. Alternatively, in a study by Bruns et al investigating the control of blood pressure, all recommendations made, regardless of appointment type, were accepted by the care team [ 8 ]. This difference in findings between studies indicates further work should be performed to identify if acceptance of pharmacist recommendations is based on the type of review and recommendation format, the team dynamic, the clinical care area, or the type of pharmacist intervention/recommendation being made.…”

“…A pre-COVID systematic review of 34 studies demonstrated that clinical pharmacy telemedicine interventions in the outpatient or ambulatory setting, primarily via phone, had an overall positive impact on chronic disease management [ 6 ], a finding corroborated by a systematic review of inpatient intensive care unit (ICU) and non-ICU telepharmacy services published in the same year [ 7 ]. The evidence supporting telepharmacy in the ambulatory care setting has continued to grow since the COVID-19 pandemic, with studies showing benefit of telepharmacy interventions in chronic diseases such as hypertension [ 8 ], diabetes [ 9 , 10 ] and in the management of anticoagulation medications [ 11 ]. Unfortunately, there are no published studies of telepharmacy interventions in chronic kidney disease (CKD) or dialysis patients to date.…”

Applications and outcomes of implementing telemedicine for hypertension management in COVID-19 pandemic: A systematic review

“…The use of telemedicine technologies, such as mobile phones and other audio-visual smart devices, has significantly transformed disease management and improved access to ambulatory and subspecialty care for patients in disadvantaged populations [ 1 – 3 ]. Mobile health (M-health), as a subset of telemedicine, involves the use of mobile phones and other wireless technologies in health care.…”

“…Patients with non-communicable diseases, such as hypertension, are particularly vulnerable to COVID-19. Therefore, disease management is of paramount importance during this pandemic [ 3 ]. additionally, the pandemic has posed challenges to the care of patients with chronic diseases, particularly hypertension [ 17 ].…”