Patients have similar preferences for pharmacists and GPs when it comes to hypertension management, according to recent research.
The study, published in the British Journal of General Practice, has investigated patient preferences for the management of hypertension.
The data were collected through an online survey including four attributes: 1) GP led – when patients book an appointment at local general practice where their blood pressure (BP) is measured and medicine changes are made by the GP; 2) Pharmacist led – patients walk in to a pharmacy where their BP is measured and medication changes are made by the pharmacists in accordance with GP’s guidance; 3) Telehealth – patients measure their BP at home on a machine which sends results to the GP who reviews the results and makes necessary changes to medication; and 4) Self-management – patients measure their BP at home and are responsible for making medication changes, according to a protocol agreed beforehand with the GP.
The researchers found no difference in patient preferences for pharmacist management, GP management, or telehealth, but a negative preference was reported when it came to self-management.
Patients also preferred scenarios that had greater reduction in cardiovascular risk, more frequent BP monitoring, and lower costs. However, when the outcome changed from the lowest (5%) to the highest (25%) risk reduction category, the likelihood that participants would choose a model of care doubled.
The authors said when introducing new models of care for hypertension to patients, discussion of the potential benefits in terms of risk reduction should be prioritised to maximise uptake.
They concluded that this was an experimental study and participant choices may not represent how individuals behave in real-world situations. Therefore, there is a need to recognise that not all patients want the same thing, and further research should focus on investigating groups of patients with similar preferences.
The study also warned that care should be taken in interpreting the results beyond the included sample. The final sample was well educated and almost all participants described themselves as white. This reflects the challenge across research studies in recruiting participants from minority groups.
Future studies should target minority groups, as these groups often have the worse cardiovascular outcomes, it advised.
According to an estimate in the study, diseases caused by hypertension cost the NHS £2 billion every year.
The National Institute for Health and Care Excellence recommends that patients with hypertension with well-controlled blood pressure (BP) need to have their it measured once a year. However, 30% of patients with hypertension currently visit their GP at least three times per year, with one in ten making more than five visits.
With their clinical knowledge and counselling skills, community pharmacists can be key players in controlling high BP, yet they remain an under-utilised resource in the management of hypertension.