Title: Improvement of blood pressure metrics through pharmacist telemedicine visits
Authors: Mojibola Awe, PharmD, Jessica Merrey, PharmD, MBA, BCPS, BCACP, BCGP, FASCP, Maxwell Ditlevson, PharmD, BCCP, Stacey Schott, MD, MPH, Abigail Tran, PharmD, BCACP, Patricia Ross, PharmD, MEdHP, BCACP, Michelle Azar, PharmD, MBA, BCPS, Ari Goldstein, MD
Objective: Audience members will be able to evaluate the effect of a clinical pharmacist-led telemedicine program on blood pressure reduction among patients with uncontrolled hypertension with or without diabetes in Johns Hopkins ambulatory cardiology clinics.
Self-Assessment Question: True or False: Factors including involvement of a multidisciplinary care team, telemedicine, and ambulatory blood pressure monitoring have been identified as strategies to improve blood pressure outcomes.
Background: Hypertension increases the risk of cardiovascular diseases. This study aimed to incorporate pharmacist-led interventions via telemedicine and ambulatory blood pressure monitoring to improve blood pressure control and quality metrics for patients.
Methods: This was a prospective, pharmacist-led quality improvement program done between November 2025 and March 2026. A quality dashboard was used to identify patients in cardiology clinics with uncontrolled hypertension per last blood pressure (BP). Chart review identified patients for direct intervention, and those included were outreached up to three times via phone and direct patient messaging. Once enrolled, an initial telemedicine visit was scheduled to assess baseline BP and heart rate (HR), current medications, diet, and exercise. Pharmacologic and non-pharmacologic interventions were made and tracked. Participants were asked to monitor their BP at home for bi-weekly for pharmacist review. These data, lifestyle factors, and any interventions made during the initial visit were reassessed during follow-up visits. Data will be reported as descriptive statistics, and a paired t-test will be used for analysis.
Results: Of 149 patients screened, 81 were outreached. Most exclusions were due to controlled BP, out-of-state location, or prior pharmacist involvement. Of those outreached, 31 agreed to an initial pharmacist visit; 19 visits occurred, 7 were no-shows, and 5 agreed only to BP monitoring via patient portal. The majority were female with a median age of 66 years. At baseline, patients were on a mean of 2 antihypertensives, and 17 (55%) performed ambulatory BP monitoring. There were 11 pharmacologic interventions recommended, including 5 new BP medications. Thirty-one nonpharmacologic interventions were recommended, primarily to start or continue ambulatory BP monitoring. Systolic and diastolic BP decreased by 15 mmHg (95% CI 7.03–22.84; p=0.0006) and 8 mmHg (95% CI 2.86–12.30; p=0.0026), respectively.
Conclusion: This study aimed to incorporate pharmacist telemedicine visits and ambulatory BP monitoring to improve BP outcomes and achieve quality metrics for cardiology clinics. Results showed 54.8% of patients who engaged met BP metrics, with clinically significant reductions in systolic (-15 mmHg) and diastolic (-8 mmHg) BP from baseline. Success was driven by increased ambulatory BP monitoring and documentation, though bi-weekly monitoring was not sustained. Telephone outreach proved most effective for patient engagement. Strengths included comprehensive visits aligned with guidelines. Limitations included small sample size and high attrition. Multimodal outreach strategies are essential for sustained engagement.
