Implementation modifications and outcomes of a pharmacist-led primary care remote hypertension service
Year: 2025
Type: article
Abstract: BACKGROUND: National guidelines recommend team-based remote blood pressure (BP) management as standard care, but implementation in actual clinical settings is complex and requires more insights from real-world practices. OBJECTIVES: We offer practical insights and share lessons learned regarding challenges and potential solutions for advancing pharmacist-led remote physiologic monitoring (RPM) for hypertension. We aim to: (1) detail key contextual factors that informed and shaped the intervention; (2) describe intervention components, noting when and why specific modifications were introduced; and (3) analyze how implementation decisions impacted outcomes over time. PRACTICE DESCRIPTION: Guided by the Exploration, Preparation, Implementation, and Sustainment framework, we describe the key practice contextual factors that contributed to implementation of RPM for hypertension. PRACTICE INNOVATION: Applying the Framework for Reporting Adaptations and Modifications to Evidence-based Interventions, we identify when and why modifications were made. We detail intervention components and various strategies used for dissemination, implementation processes, innovation integration, capacity-building, and scale-up. EVALUATION METHODS: We use descriptive statistics to report measures of reach, effectiveness, adoption, and implementation outcomes over time. Additionally, for reach and effectiveness, we use unadjusted chi-squared analyses to compare trends in proportions across early, mid, and late implementation periods. RESULTS: Over time, there was a trend toward increasing provider referrals (73 by year 3), new patient enrollments (362 in year 3), and RPM codes billed (1579 by year 3). Payor mix, a measure of program reach, saw a statistically significant improvement over time (P < 0.01), while the proportion of patients achieving target BP improved but was not statistically significant (P = 0.53). CONCLUSION: Multilevel alignment and continuous adaptation efforts contributed to successful implementation of a pharmacist-led RPM intervention for hypertension with improvement in reach over time. We share our insights as a resource for primary care practitioners, organizations, and policy makers seeking to implement RPM for hypertension.
Authors: Jennifer A. Sabatino, Natalie S. Lee, Kelli D. Barnes, Cory P. Coffey, Daniel E. Jonas, Neeraj H. Tayal
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,230
OpenAlex ID: W4415760898