P209 A TEAM-BASED APPROACH TO MANAGE BLOOD PRESSURE BETWEEN COMMUNITY PHARMACISTS AND PRIMARY HEALTH CARE PHYSICIANS BY MEANS OF VASCULAR AGE (RIESCO/TOGETHER)

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Background and Objective: Estimating arterial stiffness in Community Farmacies (CPh) has been shown to improve hypertension (HTN) management in Portugal, Austria and Spain. TOGETHER aims to evaluate whether empowering hypertensive subjects by determining arterial stiffness in CPh increases HTN control, establishing paths of lasting cooperation between Primary Care (PC) doctors and CPh. Methods: TOGETHER is a cluster-randomized, prospective study in Portugal, Austria and Spain. All consecutive expected 1260 subjects entering CPh will be offered BP measurement and ambulatory BP monitoring (ABPM) for those with high values. CPh will be randomly grouped into a usual care arm (health education associated with HTN and communication of the results to PC). In the experimental care group, early vascular aging (EVA) will additionally be assessed estimating oscillometric pulse wave velocity. The therapeutic options of EVA will be explained to patients/PC. HTN will be treated by PC according to usual clinical practice. A second evaluation with ABPM will be performed after 6 months and HTN control will be compared between the arms. The degree of patient-doctor interaction will be determined through validated surveys. Results Five fundamental unmet needs will be addressed by TOGETHER: 1) lack of HTN screening programs; 2) Implementation of the simpler and more informative EVA concept (“Your arteries are 10 years older than you”); 3) understanding CV risk on an individual basis (individual EVA) should improve patient adherence and reduce physician inertia; 4) Implementation of health educational programs, combined with the concept of EVA; 5) Higher collaboration and development of a team-based approach to HTN care between CPh and PC. Conclusions: The complementary organizational settings and strengths of CPh and PC will allow TOGETHER to create new strategies for early identification and intervention in HTN, ranging from lifestyle to medical treatment, taking social, economic, and behavioral aspects into account.

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