Cut Your Blood Pressure 3

The recently published LA Barbershop in the New England Journal of Medicine (Victor et al. N Engl J Med 2018; 378: 1291-301) solid evidence of the efficacy of a pharmacist-led medication management intervention to reduce blood pressure in black men that patronize barbershops. One of the most significant logistical inefficiencies of the LA Barbershop Study was the amount of time the pharmacists spent driving for face-to-face visits with participants. On average, each round trip was 40 miles and pharmacists drove 2 hours per day. By using telemedicine, the study team can minimize the number of face-to-face in-person visits and increase pharmacist efficiency by 25%. the study team aim to increase the scalability of our novel, evidence-based barbershop model by addressing this inefficiency with the pilot study. In the LA Barbershop trial, each participant averaged 7 in-person visits in 6 months. the study team found that the initial in-person visits between the pharmacist, barber, and patron were essential for establishing trust as well as obtaining baseline electrolyte and serum creatinine levels (with our validated point-of-care device, iSTAT). However, once rapport has been established and blood pressure control achieved, the study team postulate that the effect can be maintained remotely with telemedicine. Our data indicate that most patients' can achieve their blood pressure goal in 3 months or less. the study team propose replacing additional in-person visits with telemonitoring (via Skype or FaceTime) at this juncture, provided blood chemistries are stable. the study team plan to pilot this in 20 patients from 2 to 3 barbershops for 12 months.