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This morning I am going to consider self-monitoring of BP and its management by pharmacists. In the UK this could form an important part of remote management in PCNs @Shahed__Ahmad @AnastasiaSMihai @OxPrimaryCare @_AliAlbasri @BevGreen6 @StefanoOmboni
1/ There is good quality trial evidence from the US that pharmacists using web enabled digital interventions can manage hypertension successfully working with medics. @BevGreen6 and team showed this in 2008: active and intensive management needed. https://pubmed.ncbi.nlm.nih.gov/18577730/ ">https://pubmed.ncbi.nlm.nih.gov/18577730/...
2/ Further work by Karen Margolis included pharmacist medication titration, longer follow-up (up to 24 months) and automated transmission of readings with further clear benefit:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4311883/">https://www.ncbi.nlm.nih.gov/pmc/artic... https://pubmed.ncbi.nlm.nih.gov/30646139/ ">https://pubmed.ncbi.nlm.nih.gov/30646139/...
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4311883/">https://www.ncbi.nlm.nih.gov/pmc/artic... https://pubmed.ncbi.nlm.nih.gov/30646139/ ">https://pubmed.ncbi.nlm.nih.gov/30646139/...
3/ A meta-analysis at around the same time put this in context with other pharmacist interventions in hypertension (overall 7.6/3.9mmHg reduction vs usual care) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4187511/">https://www.ncbi.nlm.nih.gov/pmc/artic...
4/ @_AliAlbasri ’s work shows that community pharmacists in the UK can manage hypertension medication with little need to refer back to GPs. https://pubmed.ncbi.nlm.nih.gov/29970396/ ">https://pubmed.ncbi.nlm.nih.gov/29970396/...
5/ @_AliAlbasri also showed that self-monitored BP and pharmacist monitored BP appear similar meaning that protocols for pharmacy management can be translated directly to use SMBP. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5585128/">https://www.ncbi.nlm.nih.gov/pmc/artic...
6/ @StefanoOmboni has developed telepharmacy systems in Italy (evidence reviewed here: https://pubmed.ncbi.nlm.nih.gov/30546052/?from_term=omboni+s+telemonitoring&from_pos=5)">https://pubmed.ncbi.nlm.nih.gov/30546052/... and is speaking about his these and his COVID-19 experiences next Thursday 4/6/2020 register here https://us02web.zoom.us/webinar/register/WN_sqNSy-N_RP-fa6U4GYS7aQ…">https://us02web.zoom.us/webinar/r...
