Evaluation of a hypertension medication therapy management program in patients with diabetes

Objective: To evaluate the effect of a 9-month community pharmacy-based medication therapy management (MTM) program on quality of care in patients with diabetes and hypertension. Design: Randomized controlled trial. Setting: Tulsa, OK, between November 2005 and July 2007. Patients: 52 patients with diabetes and hypertension who were enrolled in a managed care organization. Intervention: During monthly visits, intervention group participants received MTM services for hypertension and diabetes management. Main outcome measures: Systolic blood pressure (SBP), percentage at goal blood pressure (<130/80 mm Hg), and antihypertensive medication adherence. Results: The mean intervention group SBP decreased 17.32 mm Hg, whereas the mean control group SBP level increased 2.73 mm Hg (P = 0.003). The percentage of patients at goal blood pressure increased from 16.0% to 48.0% in the intervention group and decreased from 20.0% to 6.67% in the control group. Intervention group participants were 12.92 times more likely than control group participants to achieve goal blood pressure (P = 0.021). Although the mean adherence rate in the intervention group increased 7.0% while remaining fairly constant in the control group (-0.7%), this group difference was not statistically significant. Conclusion: A community pharmacy-based hypertension MTM program was effective in improving blood pressure control among managed care enrollees with diabetes and hypertension. Community pharmacists are strategically positioned to provide MTM services and effectively communicate with providers to improve quality of care for patients.