Online assistance from pharmacists helps control high blood pressure, study finds

Online-based care from a pharmacist helped people control their high blood pressure more than twice as well as people who did not have the additional resources, according to a study published in Wednesday's issue of the Journal of the American Medical Association, the Seattle Post-Intelligencer reports.

For the three-year study, 778 Group Health members with uncontrolled high blood pressure and Internet access were randomly assigned to one of three groups to determine which resources better helped them control their blood pressure. The first group was given standard care, which included blood pressure pamphlets and access to physician e-mail and Group Health's Web site. The second group's members received home blood pressure monitors and access to Group Health's Web site, as well as training on using the Web site and sending blood pressure results to their physicians online. The third group also received home blood pressure monitors, Web site training and online care from pharmacists about every two weeks. Through e-mail, the pharmacists reminded people to send in blood pressure readings, helped patients develop lifestyle goals and adjusted medication doses as needed.

The study found that 31% of patients in the standard-care group were able to control their blood pressure, meaning their average reading was below 140/90, compared with 36% in the second group and nearly 60% in the third group (Black, Seattle Post-Intelligencer, 6/24). The systolic reading after one year decreased by an average of 5.3 points in the first group, 8.2 points in the second group and 14.2 points in the third group. In addition, patients receiving typical care took an average of 1.69 medications daily for blood pressure, compared with patients in the third group who took an average of 2.16 medications. Patients in the pharmacist group also maintained more frequent contact with their physicians through secure messaging (Song, Seattle Times, 6/25). Beverly Green, a Group Health family physician and lead researcher of the study, said that the online-based care nearly tripled the percentage of people with the highest blood pressure who were able to control their conditions (Seattle Post-Intelligencer, 6/25).

An editorial accompanying the study, co-written by the president of the American Heart Association, stated that it might be difficult to replicate the study elsewhere because Group Health operates its own clinics and employs its own physicians, giving the company the integrated health records and financial incentives to manage chronic diseases (Seattle Times, 6/25).

The study is available online. An extract of the editorial also is available online.