Part 2. Clinical and Economic Outcomes in the Hypertension and COPD Arms of a Multicenter Outcomes Study

Abstract Objective To evaluate the impact of pharmaceutical care on selected clinical and economic outcomes in patients with hypertension chronic obstructive pulmonary disease (COPD) in ambulatory care settings. Design Clinic patients with hypertension or COPD were radomly assigned to a treatment group (pharmaceutical care) or a control group (traditional pharmacy care) over a six·month period. Clircal pharmacists and pharmacy residents conducted the protocols. There were 133 evaluable patients (63 treatment and 70 control) in the hypertension study arm and 98 evaluable patients (43 treatment and 55 control) in the COPD study arm. Setting 10 Departments of Veerans Affairs medical centers and 1 academic medical center. Interventions Patient-centered pharmaceutical care model (employing stadardized care) implemented by clinical pharmacy residents. Main Outcome Measures Patient knowledge, medication compliance, and health resource use. Results The hypertension treatment group had a significantly greater reduction in systolic blood pressure from visit 1 to visit 5 than did the control group. In the COPD study arm, trends were positive in the treatment group for patient ratings of symptom interference with activities and dyspnea measures. There was a significant difference between the hypertension treatment and control group for compliance. There were no significant changes in compliance scores in the COPD study arm. Mean number of hospitalization and other health care provider visits was higher for the hypertension control group. For patients with COPD, hospitalizations increased in the control group, and the number of other health care provider visits was higher in the control group. Conclusion Pharmacists' participation in a pharmaceutical care program resulted in disease state improvement in ambulatory patients with hypertension and COPD.