For one month, the total revenue collected by using blood pressure kiosks was generated and measured to identify how valuable kiosks could be in identifying hypertensive patients. Studies currently show that hypertension affects twenty to thirty percent of North American adults, and one-half of this hypertensive population remain uncontrolled. Uncontrolled hypertension leads to many adverse effects, some of which include heart failure, myocardial infarction, and stroke. By implementing blood pressure kiosks, patients may more easily obtain their blood pressure readings, and therefore find help from pharmacists if deemed necessary.
From this study, researchers concluded that on average, 189 hypertensive patients per month would qualify for a drug review and patient consult with a pharmacist. These reviews and consults would qualify for revenue collected. Overall, more than 7.5 million readings from 341 pharmacies were taken on the blood pressure kiosks. Through calculations, researchers determined by pharmacies could collect an average of $12,270 annually in revenue from MTM services provided to patients who discovered their hypertension. It is evident that blood pressure kiosks are very valuable in a pharmaceutical setting.
I found this article interesting because I myself have used a similar kiosk at a local pharmacy. Although I had already known that I was not hypertensive and I was merely just playing with the technology, I did wonder how beneficial the kiosk was to the company that I was in. From this study, I have no doubt implementing a blood pressure kiosk can help pharmacists generate more patients, thereby providing the assistance and improving patient outcomes.
Houle SK, Chuck AW, Tsuyuki RT. Blood pressure kiosks for medication therapy management programs: Business opportunity for pharmacists.. J Am Pharm Assoc. 2003;52:188-194.
The SPRINT research group conducted a study to determine the beneficial effects of intensive treatment options for hypertension as compared to the standard methods and goals of high blood pressure medication therapy. In the study, researchers tracked the treatment outcomes of 9,361 patients over the age of 50, systolic blood pressure from 130-180 mm Hg, and increased risk of cardiovascular disease. They were separated into two groups, one intensive care group (blood pressure goal of <120/80), and a standard care group (blood pressure goal of <140/90), and treated accordingly to lower blood pressure to respective goals. The two groups were then monitored over the course of five years to measure adverse cardiovascular outcomes including myocardial infarction, stroke, coronary artery disease, heart failure, or death from cardiovascular complications.
The study found that those treated for hypertension with intensive therapeutic goals were less likely to experience adverse cardiovascular outcomes or death associated with cardiovascular complications as compared to the study group that was treated with the current standard goals of blood pressure therapy. Intensive treatment showed protective effects on primary adverse outcomes (hazard ratio: 0.75; 95% confidence interval [CI], 0.64 to 0.89; P<0.001) over the standard treatment options, although they generally showed increased risks of side effects from hypertension medications including orthostatic hypotension, syncope, and bradycardia. The trial was stopped short of its goal at a median of 3.26 years due to the clear protective effects of the intensive care study.
This study is important to our profession, because as pharmacists we may see the standards of hypertension care change to reflect better patient outcomes. The result would be increased concurrent blood pressure medications to reach lower blood pressure goals than under previous guidelines. The increased potential for drug-drug interactions and adverse effects from different classes of medications will increase the necessity of appropriate MTM techniques. The question that was raised by the study is an important consideration before treatment guidelines should be changed. Is the potential for fewer adverse outcomes of hypertension via intensive treatments worth the increased risk of drug interactions and adverse side effects from more prescriptions? What do you think?
The SPRINT Research Group. A Randomized Trial of Intensive Versus Standard Blood-Pressure Control. N Engl J Med. 2015;373:2103-16. DOI: 10.1056/NEJMoa1511939 (Published November 26, 2015)