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Erschienen in: Journal of General Internal Medicine 1/2020

28.10.2019 | Original Research

Primary Care Providers’ Acceptance of Pharmacists’ Recommendations to Support Optimal Medication Management for Patients with Diabetic Kidney Disease

verfasst von: Leah L. Zullig, PhD, Shelley A. Jazowski, MPH, Clemontina A. Davenport, PhD, Clarissa J. Diamantidis, MD, MHS, Megan M. Oakes, MPA, Sejal Patel, BPharm, BCGP, Jivan Moaddeb, PharmD, Hayden B. Bosworth, PhD

Erschienen in: Journal of General Internal Medicine | Ausgabe 1/2020

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Abstract

Background

Patients with diabetic kidney disease (DKD) often struggle with blood pressure control. In team-based models of care, pharmacists and primary care providers (PCPs) play important roles in supporting patients’ blood pressure management.

Objective

To describe whether PCPs’ acceptance of pharmacists’ recommendations impacts systolic blood pressure (SBP) at 36 months.

Design

An observational analysis of a subset of participants randomized to the intervention arm of the Simultaneous risk factor control using Telehealth to slOw Progression of Diabetic Kidney Disease (STOP-DKD) study.

Participants

STOP-DKD participants for whom (1) the pharmacist made at least one recommendation to the PCP; (2) there were available data regarding the PCP’s corresponding action; and (3) there were SBP measurements at baseline and 36 months.

Intervention

Participants received monthly telephone calls with a pharmacist addressing health behaviors and medication management. Pharmacists made medication-related recommendations to PCPs.

Main Measures

We fit an unadjusted generalized linear mixed model to assess the association between the number of pharmacists’ recommendations for DKD and blood pressure management and PCPs’ acceptance of such recommendations. We used a linear regression model to evaluate the association between PCP acceptance and SBP at 36 months, adjusted for baseline SBP.

Key Results

Pharmacists made 176 treatment recommendations (among 59 participants), of which 107 (61%) were accepted by PCPs. SBP significantly declined by an average of 10.5 mmHg (p < 0.01) among 47 of 59 participants who had valid measurements at baseline and 36 months. There was a significant association between the number of pharmacist recommendations and the odds of PCP acceptance (OR 1.19; 95%CI 1.00, 1.42; p < 0.05), but no association between the number of accepted recommendations and SBP.

Conclusions

Pharmacists provided actionable medication-related recommendations. We identified a significant decline in SBP at 36 months, but this reduction was not associated with recommendation acceptance.

Trial Registration

NCT01829256
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Metadaten
Titel
Primary Care Providers’ Acceptance of Pharmacists’ Recommendations to Support Optimal Medication Management for Patients with Diabetic Kidney Disease
verfasst von
Leah L. Zullig, PhD
Shelley A. Jazowski, MPH
Clemontina A. Davenport, PhD
Clarissa J. Diamantidis, MD, MHS
Megan M. Oakes, MPA
Sejal Patel, BPharm, BCGP
Jivan Moaddeb, PharmD
Hayden B. Bosworth, PhD
Publikationsdatum
28.10.2019
Verlag
Springer US
Erschienen in
Journal of General Internal Medicine / Ausgabe 1/2020
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-019-05403-x

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