Thursday, May 17, 2012

Amazingly cool research in progress

I read a really neat article (that you need a subscriptions to read, although I think it's a free subscription) about research in MN about how having people with high blood pressure measure their blood pressure at home can lower their blood pressure even more than just medications, and how pharmacists' interacting with patients based on that data works and is probably cost-effective.

The short summary of what they're doing is: patients newly diagnosed with high blood pressure in the study group get a home BP monitor and it digitally records readings and syncs them with a secure health record online.  Pharmacists can see that record and followed-up with patients by a phone call every 2-4 weeks to see how things are going and are authorized by a collaborative practice agreement to prescribe if med changes are needed.  After the first 6 months of the study, 72% of those getting pharmacist interventions had their blood pressure down to goal while only 45% of those getting usual care (doctor visit about every 6 months, first follow-up at 1 or 2 months after starting a med).

That's pretty amazing when you think about it.  An extra 27% of people getting their blood pressure under control within 6 months of starting treatment is pretty stellar.

While this study doesn't split out whether it's the charting of blood pressure electronically or the chatting with the pharmacist that improve outcomes, I like to think it's talking to someone more often.  Those in the pharmacist intervention group were on an average of 2.3 meds at 6 months compared to 1.6 meds in the usual care group, suggesting that pharmacists knew when to give up the first treatment and increase to a second med while doctors either didn't see patients often enough to make this intervention, or they didn't realize it was time to do it so soon.  The study is continuing to a year and maybe beyond that, so the final results are something to wait to check out, but it's still neat.  #pharmacygeek

How awesome is this research?  Chatting with a pharmacist for just 10-15 minutes every 2-4 weeks while monitoring blood pressure at home helps a lot for patients with high blood pressure.  While it's preliminary research, it's also very promising.  There's a good deal of other research that supports similar conclusions: talking to someone pretty often about fixing your health helps people improve it.

I have a piece of artwork that I'll put on my desk when I have one (or on my counter, depending on where I end up working) that says the following:

If a pretty picture and a cute saying are all it takes to motivate you, you have a very easy job. The kind robots will be doing soon.

Nobody but a real person can talk to another real person about their health, and nobody but a real person can coach another person to improve their lifestyle.  My future job is secure!

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