Patients do not prefer GP over pharmacist for hypertension management, study finds

Research published in the British Journal of General Practice has shown that there is no difference in patient preference when it comes to whether a GP or pharmacist helps manage their hypertension.

Electronic blood pressure monitor

Patients are just as happy to have their hypertension managed by a pharmacist as by their GP, a study in the British Journal of General Practice has shown.

However, patients are more likely choose a new model of care if they understand its benefits in terms of cardiovascular risk reduction. 

The researchers carried out an online survey of patients with hypertension in the UK to investigate patient preferences for the management of hypertension.

The survey was designed to assess patient preference for the management of hypertension across four attributes. The first of these was the model of care, with options including scheduling an appointment with a GP; attending a walk-in service at their local pharmacy; measuring blood pressure (BP) at home and automatically transmitting the results to the GP; or measuring BP at home and making necessary medication changes, according to a protocol that has been agreed with the GP in advance.

The other attributes included frequency of measurement, from monthly to yearly; annual cost to the NHS, from £50 to £500; and levels of risk reduction for cardiovascular risk over the next 5 years, from a 5% reduction to a 25% reduction.

Overall, the researchers found no evidence of a difference in patient preferences for GP management, pharmacist management or telehealth, although, patients were found to prefer GP management over managing their hypertension on their own.

Patients also preferred scenarios that had a greater reduction in cardiovascular risk, more frequent BP monitoring and lower costs. Scenario analysis showed that 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 concluded that 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.

Since the inception of the study, NHS England has invested significantly in practice-based pharmacists. The authors acknowledged this and said that management of hypertension was “one option where practice-based pharmacists could be engaged”.

Last updated
Citation
The Pharmaceutical Journal, August 2019;Online:DOI:10.1211/PJ.2019.20206939