Remote Blood Pressure (BP) Monitoring with Integrated Clinical Pharmacy Services Improve BP Control
Purpose: It is estimated that 70-90% of renal transplant recipients have hypertension and many require one or more antihypertensive agents to maintain goal BP targets in the post-operative period. Poor control of hypertension is the most significant non-immunologic cause of renal allograft loss.
Method: Abacus and a large hospital have designed and implemented an intervention that includes a dedicated transplant clinical pharmacist who provides Medication Therapy Management (MTM) services to renal transplant recipients and incorporates Home Electronic BP Monitoring to enhance the quality of care to renal transplant recipients. Patients are given an electronic BP cuff (uploadable via a cellular hub, home computer or kiosk) and instructed to monitor at home. Their BP readings are analyzed via a clinical dashboard, and their medications are titrated and/or changed by the transplant clinical pharmacist in conjunction with a pharmacist-physician collaborative care agreement.
Results: The present results show both statistically and clinically meaningful reductions in BP in renal transplant patients. Furthermore, the impact of remote monitoring coupled with clinical pharmacy services on healthcare-associated costs is highlighted by comparing the number and probability of 30-day readmission rates in the pre-intervention period (January 1, 2011 to December 31, 2011) and the post-prevention period (January 1, 2013 to December 31, 2013). There was an estimated absolute reduction in the risk of re-hospitalization of 16% or a relative reduction in risk of hospitalization of 43%. It is estimated that each 30-day readmission after transplant costs an average amount of $10,551.
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