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Methods Papers

The Team Education and Adherence Monitoring (TEAM) Trial

Pharmacy Interventions to Improve Hypertension Control in Blacks

Bonnie L. Svarstad, PhD; Jane Morley Kotchen, MD, MPH; Theresa I. Shireman, PhD, RPh; Stephanie Y. Crawford, PhD, MPH; Pamela A. Palmer, RPh; Eva M. Vivian, PharmD and Roger L. Brown, PhD

From the Social and Administrative Sciences (B.L.S., P.A.P.) and the Pharmacy Practice Division (E.M.V.) School of Pharmacy, and the Schools of Nursing and Medicine (R.L.B.), University of Wisconsin-Madison, Madison, Wis; the Department of Population Health (J.M.K.), Medical College of Wisconsin, Milwaukee, Wis; the Department of Preventive Medicine and Public Health (T.I.S.), University of Kansas Medical Center, Kansas City, Kan; and the Department of Pharmacy Administration (S.Y.C.), College of Pharmacy, University of Illinois at Chicago, Chicago, Ill.

Correspondence to Bonnie L. Svarstad, PhD, Professor Emerita, University of Wisconsin-Madison, Madison School of Pharmacy, 777 Highland Ave, Madison, WI 53705. E-mail blsvarstad{at}pharmacy.wisc.edu

Recent studies suggest that involving pharmacists is an effective strategy for improving patient adherence and blood pressure (BP) control. To date, few controlled studies have tested the cost-effectiveness of specific models for improving patient adherence and BP control in community pharmacies, where most Americans obtain prescriptions. We hypothesized that a team model of adherence monitoring and intervention in corporately owned community pharmacies can improve patient adherence, prescribing, and BP control among hypertensive black patients. The Team Education and Adherence Monitoring (TEAM) Trial is a randomized controlled trial testing a multistep intervention for improving adherence monitoring and intervention in 28 corporately owned community pharmacies. Patients in the 14 control pharmacies received "usual care," and patients in the 14 intervention pharmacies received TEAM Care by trained pharmacists and pharmacy technicians working with patients and physicians. Data collectors screened 1250 patients and enrolled 597 hypertensive black patients. The primary end points were the proportion of patients achieving BP control and reductions in systolic and diastolic BP measured after 6 and 12 months. Secondary end points were changes in adherence monitoring and intervention, patient adherence and barriers to adherence, prescribing, and cost-effectiveness. Researchers also will examine potential covariates and barriers to change. Involving pharmacists is a potentially powerful means of improving BP control in blacks. Pharmacists are in an excellent position to monitor patients between clinic visits and to provide useful information to patients and physicians.

Key Words: hypertension • compliance/adherence • pharmacy • African Americans/Blacks

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