Abstract: SA-PO0468
Clinician and Clinical Pharmacist Perspectives on Pharmacist-Guided Self-Management of Hypertension in Patients with CKD
Session Information
- CKM: Clinical - Screening, Population Management, Care Disparities, and Patient-Centered Outcomes
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Cardiovascular-Kidney-Metabolic Health
- 602 Cardiovascular-Kidney-Metabolic Health: Clinical
Authors
- Good, Mary K., Iowa City VA Medical Center, Iowa City, Iowa, United States
- Ball, Daniel D., Iowa City VA Medical Center, Iowa City, Iowa, United States
- Yamada, Masaaki, Iowa City VA Medical Center, Iowa City, Iowa, United States
- Reisinger, Heather, Iowa City VA Medical Center, Iowa City, Iowa, United States
- Kennelty, Korey, The University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, United States
- Swee, Melissa L., Iowa City VA Medical Center, Iowa City, Iowa, United States
- Geasland, Katharine M., Iowa City VA Medical Center, Iowa City, Iowa, United States
- Bailey, George, Iowa City VA Medical Center, Iowa City, Iowa, United States
- Jalal, Diana I., Iowa City VA Medical Center, Iowa City, Iowa, United States
Background
Managing hypertension (HTN) is critical to reduce kidney and cardiovascular complications in chronic kidney disease (CKD). As part of a clinical trial to improve blood pressure (BP) management in Veterans with CKD, we evaluated provider perceptions of pharmacist-guided self-management of HTN and their considerations for widespread implementation within the Veterans Health Administration healthcare system.
Methods
We conducted this qualitative analysis as part of a single-center clinical trial that randomized 160 Veterans with CKD to pharmacist-guided self-management of HTN or self-monitoring of home BP + standard of care. We completed two virtual focus groups with clinical pharmacists (actively involved in supporting patients enrolled in the study) and clinicians (primary care providers or specialists caring for CKD patients). Transcripts were coded and analyzed using a thematic approach guided by the CFIR 2.0 framework.
Results
Participants included 6 pharmacists and 6 clinicians. Themes in the data included: (1) Trust and Communication sustained patient education on proper medication management and supported patient-pharmacist cooperation when issues arise. (2) Culture Shift within the Healthcare System included providers moving from surveillance and control of medication management to support and guidance to ensure the success of the intervention. (3) Patient Empowerment and Knowledge could be enhanced through specific education about BP monitoring, medication management, and side effects, but some providers had concerns about patient adherence. (4) Resources Needed for Integration included drawing on multiple staff roles within the care team and ensuring information transfer between clinicians and pharmacists. (5) Managing Unknowns with Flexibility arose in the face of unpredictable workloads with self-management of HTN and suggested the need for adaptability of protocols to meet the needs of patients. Overall, participants emphasized effective communication and a commitment to shared expectations among patients, clinicians, and pharmacists as central to successful implementation.
Conclusion
Themes covered multiple levels from interpersonal trust to system factors. Successful implementation of pharmacist-guided self-management of HTN in CKD will require enhancing patient-clinician-pharmacist communication, culture shifts toward shared medication management, and adaptive workflows.
Funding
- Veterans Affairs Support