A Pharmacist Intervention for Monitoring and Treating Hypertension Using Bidirectional Texting

使用双向短信监测和治疗高血压的药剂师干预

基本信息

批准号：
10477383
负责人：
Barry L Carter
金额：
$ 66万
依托单位：
UNIVERSITY OF IOWA
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-15 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10477383
关键词：
Ambulatory Blood Pressure Monitoring Blood Pressure Cardiovascular Diseases Caring Cause of Death Cellular Phone Cessation of life Clinic Clinical Clinical Pharmacists Clinical Pharmacy Service Collaborations Control Groups Custom Diagnosis Discipline Effectiveness of Interventions Elderly Funding Goals Health Health Personnel Healthcare Home Home Blood Pressure Monitoring Hour Hypertension Improve Access Intervention Investments Knowledge Managed Care Measurement Medical Modeling Monitor Morbidity - disease rate Myocardial Infarction National Heart, Lung, and Blood Institute Paper Patients Pharmacists Physician Executives Physicians Physicians&apos Offices Primary Health Care Privatization Provider Reading Research Resources Risk Rural Rural Population Services Smoking Stroke Technology Text Messaging Time Work adherence rate base blood pressure control blood pressure reduction cost cost effective cost effectiveness follow-up group intervention hypertension control improved medically underserved population member mortality novel prevent public health relevance rural area rural dwellers rural patients telehealth two way texting virtual web based interface

项目摘要

ABSTRACT Hypertension causes an estimated 395,000 deaths in the US each year: one out of every six deaths. Hypertension is second only to smoking as a modifiable cause of death in the US. Poor blood pressure (BP) control increases the risk of myocardial infarction, stroke and death and is often due to delays in treatment intensification. We have developed a telehealth service called Centralized Healthcare Solutions that has successfully delivered clinical pharmacy services remotely to private physician offices, especially in small medical offices and rural locations. In our prior work, we demonstrated that a physician-pharmacist collaboration could cost effectively reduce BP, but pharmacists spent a considerable proportion of their time obtaining and aggregating patients' home BP measurements. Thus, we have developed an additional m- health solution called What's your BP? (WyBP), a custom- built bi-directional SMS-based (short message service, or texting) platform. WyBP is inexpensive (i.e., does not require investment in smartphone technology, or WiFi), acceptable to a broad range of patients (including the elderly and rural populations), scalable to subject volume observed in busy clinical settings, and easily integrated into typical clinic workflows. In two pilots, we demonstrated a high rate of adherence, indicating that patients were willing and able to take home BP measurements and send them to our research team. This proposal combines our two prior efforts to use remotely located pharmacists and bi-directional texting to improve efficiencies, reduce cost and improve access to a dedicated pharmacist. A major gap in our knowledge is whether the potency of a “virtual” team member can be improved by home BP monitoring with technological support, especially in small medical offices. The goal of this proposal is to evaluate whether our scalable SMS approach combined with a pharmacist-based intervention improves BP management cost effectively. To achieve this objective, we will determine if our intervention leads to decreases in BP; determine if our intervention leads to intensification of therapy; and determine the cost effectiveness of the intervention. At the end of this project, we expect to provide a novel, scalable and cost-effective approach for treating hypertension in rural populations by expanding the feasibility, scalability and dissemination of the Centralized Healthcare Solutions intervention. The intervention has important

抽象的据估计，美国每年有 395,000 人死于高血压：六分之一的人死于高血压。在美国，高血压是仅次于吸烟的第二大可改变的死亡原因。控制不当会增加心肌梗死、中风和死亡的风险，通常是由于治疗延误造成的我们开发了一种称为集中医疗解决方案的远程医疗服务。成功向私人医生办公室远程提供临床药学服务，特别是在小型诊所在我们之前的工作中，我们证明了医生兼药剂师。合作可以有效地降低血压，但药剂师花费了相当大的时间获取并汇总患者的家庭血压测量结果因此，我们开发了额外的 m-。名为“你的血压是多少？”（WyBP）的健康解决方案，是一种基于短信的定制双向短信 WyBP 服务或短信）平台价格低廉（即不需要投资智能手机）。技术或 WiFi），为广泛的患者（包括老年人和农村人口）所接受，可根据繁忙临床环境中观察到的受试者量进行扩展，并轻松集成到典型诊所中在两个试点中，我们表现出了很高的依从率，这表明患者愿意并且愿意。能够将血压测量值带回家并发送给我们的研究团队该提案结合了我们的两个。在使用远程药剂师的努力和双向短信之前，可以提高效率，减少我们知识的一个主要差距是药效是否有效。在技术支持下，可以通过家庭血压监测来改善“虚拟”团队成员的健康状况，尤其是该提案的目标是评估我们的 SMS 方法是否可扩展。与基于药剂师的干预相结合，可以有效地提高血压管理成本，以实现这一目标。目标，我们将确定我们的干预是否会导致血压下降；强化治疗；并在结束时确定干预措施的成本效益。项目，我们希望为农村地区的高血压治疗提供一种新颖、可扩展且具有成本效益的方法通过扩大集中医疗保健的可行性、可扩展性和传播来惠及人口解决方案的干预具有重要意义。