Randomized Trial of the Effect of Pharmacist Prescribing on Improving Blood Pressure in the Community: The Alberta Clinical Trial in Optimizing XXXX (RxACTION).

@entity1 @entity551 @entity101
BACKGROUND: @entity101 control rates remain suboptimal. Pharmacists' scope of practice is evolving, and their position in the community may be ideal for improving @entity101 care. We aimed to study the impact of pharmacist prescribing on blood pressure (BP) control in community-dwelling @entity1 . METHODS AND RESULTS: We designed a @entity1 -level, randomized, controlled trial, enrolling adults with above-target BP (as defined by Canadian guidelines) through community pharmacies, hospitals, or primary care teams in 23 communities in Alberta. Intervention group @entity1 received an assessment of BP and cardiovascular risk, education on @entity101 , prescribing of antihypertensive medications, laboratory monitoring, and monthly follow-up visits for 6 months (all by their pharmacist). Control group @entity1 received a wallet card for BP recording, written @entity101 information, and usual care from their pharmacist and physician. Primary outcome was the change in systolic BP at 6 months. A total of 248 @entity1 (mean age, 64 years; 49% male) were enrolled. Baseline mean  SD systolic/diastolic BP was 150  14/84  11 mm Hg. The intervention group had a mean  @entity551 at 6 months of 18.3  1.2 compared with 11.8  1.9 mm Hg in the control group, an adjusted difference of 6.6  1.9 mm Hg (P=0.0006). The adjusted odds of @entity1 achieving BP targets was 2.32 (95% confidence interval, 1.17-4.15 in favor of the intervention). CONCLUSIONS: Pharmacist prescribing for @entity1 with @entity101 resulted in a clinically important and statistically significant reduction in BP. Policy makers should consider an expanded role for pharmacists, including prescribing, to address the burden of @entity101 . CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00878566.
