Page 8 CirculationCardiovascularQualityandOutcomes

Magid et al Pharmacist-Led, Heart360 Home BP Program 7

We acknowledge several limitations. The study was con- Physicians; American Association of Cardiovascular and Pulmonary Re-
ducted in a single healthcare system with an EHR and clinical habilitation; Preventive Cardiovascular Nurses Association. ACCF/AHA
2009 performance measures for primary prevention of cardiovascular dis-
pharmacy specialists; therefore, the results may not be appli- ease in adults: a report of the American College of Cardiology Foundation/
cable to all settings. To participate in the intervention, patients American Heart Association Task Force on Performance Measures (Writ-
had to have access to a computer and the Internet, which may ing Committee to Develop Performance Measures for Primary Prevention
not be available to all patients with hypertension. Because of Cardiovascular Disease) developed in collaboration with the American
Academy of Family Physicians; American Association of Cardiovascu-
outcomes were assessed only at 6 months, the durability of lar and Pulmonary Rehabilitation; and Preventive Cardiovascular Nurses
the intervention effects beyond this time frame is unknown. Association: endorsed by the American College of Preventive Medicine,
Because patients ≥80 years of age were excluded, the general- American College of Sports Medicine, and Society for Women’s Health
Research. J Am Coll Cardiol. 2009;54:1364–1405.
izability of the findings to this age group is unknown. Finally, 4. Law MR, Morris JK, Wald NJ. Use of blood pressure lowering drugs in the
our ability to assess medication adherence was limited by the prevention of cardiovascular disease: meta-analysis of 147 randomised tri-
relatively short 6-month time frame and the challenge in using als in the context of expectations from prospective epidemiological stud-
ies. BMJ. 2009;338:b1665.
pharmacy refill data to assess adherence during periods when 5. Parati G, Omboni S, Albini F, Piantoni L, Giuliano A, Revera M, Illyes
changes to the antihypertensive medication regimen were M, Mancia G; TeleBPCare Study Group. Home blood pressure telemoni-
frequent. toring improves hypertension control in general practice: the TeleBPCare
study. J Hypertens. 2009;27:198–203.
Conclusion 6. Magid DJ, Ho PM, Olson KL, Brand DW, Welch LK, Snow KE, Lam-
bert-Kerzner AC, Plomondon ME, Havranek EP. A multimodal blood
A pharmacist-led, American Heart Association Heart360 pressure control intervention in 3 healthcare systems. Am J Manag Care.
Web-enabled home BP intervention led to higher rates of BP 2011;17:e96–e103.
control and larger BP reductions than UC for patients with 7. Bosworth HB, Powers BJ, Olsen MK, McCant F, Grubber J, Smith V,
Gentry PW, Rose C, Van Houtven C, Wang V, Goldstein MK, Oddone
uncontrolled hypertension. Patients enrolled in the interven- EZ. Home blood pressure management and improved blood pressure
tion also reported significantly greater satisfaction with their control: results from a randomized controlled trial. Arch Intern Med.
2011;171:1173–1180.
hypertension care than patients receiving UC. Future research 8. Green BB, Cook AJ, Ralston JD, Fishman PA, Catz SL, Carlson J, Carrell
should focus on translating the intervention to other settings D, Tyll L, Larson EB, Thompson RS. Effectiveness of home blood pres-
and patient populations and to assessing the sustainability and sure monitoring, Web communication, and pharmacist care on hyperten-
cost-effectiveness. sion control: a randomized controlled trial. JAMA. 2008;299:2857–2867.
9. Agarwal R, Bills JE, Hecht TJ, Light RP. Role of home blood pressure
Acknowledgments monitoring in overcoming therapeutic inertia and improving hyperten-
sion control: a systematic review and meta-analysis. Hypertension.
We would like to thank Heather Nuanes and Susan Shetterly for their 2011;57:29–38.
contributions to the conduct of this study. We would also like to thank 10. Rinfret S, Lussier MT, Peirce A, Duhamel F, Cossette S, Lalonde L,
the primary care clinical pharmacy specialists for their hard work, Tremblay C, Guertin MC, LeLorier J, Turgeon J, Hamet P; LOYAL Study
clinical expertise and support of this project. Investigators. The impact of a multidisciplinary information technology-
supported program on blood pressure control in primary care. Circ Car-
diovasc Qual Outcomes. 2009;2:170–177.
Source of Funding 11. Godwin M, Lam M, Birtwhistle R, Delva D, Seguin R, Casson I, Mac-
The study was funded in part by the American Heart Association. The Donald S. A primary care pragmatic cluster randomized trial of the use of
content is solely the responsibility of the authors and does not neces- home blood pressure monitoring on blood pressure levels in hypertensive
sarily represent the official views of the American Heart Association. patients with above target blood pressure. Fam Pract. 2010;27:135–142.
12. Pickering TG, Miller NH, Ogedegbe G, Krakoff LR, Artinian NT, Goff
D; American Heart Association; American Society of Hypertension; Pre-
Disclosures ventive Cardiovascular Nurses Association. Call to action on use and re-
None. imbursement for home blood pressure monitoring: executive summary: a
joint scientific statement from the American Heart Association, American
Society of Hypertension, and Preventive Cardiovascular Nurses Associa-
tion. Hypertension. 2008;52:1–9.
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