Abstract 21: Telemedicine And The Barbershop Model Of Hypertension Care For Black Men

• Published in: Hypertension (Dallas, Tex. 1979) Vol. 76; no. Suppl_1
• Main Authors: Blyler, Ciantel A, Rashid, Mohamad, Moy, Norma B, Kemp, Kayslee A, Rader, Florian
• Format: Journal Article
• Language: English
• Published: 01.09.2020
• ISSN: 0194-911X; 1524-4563
• DOI: 10.1161/hyp.76.suppl_1.21

Abstract only Background: The Los Angeles Barbershop Blood Pressure Study (LABBPS) demonstrated both efficacy and sustainability of a new model of hypertension (HTN) care for non-Hispanic black men that links health promotion by barbers to medication management by specialty-trained pharmacists. Barriers to scaling the model include logistical inefficiencies that contribute to the cost of the intervention. Most notable was the amount of time pharmacists spent traveling between barbershops. To address this, we tested whether telemedicine (remote follow-up) could be substituted for in-person visits after blood pressure (BP) control was achieved. Methods: We enrolled 10 black male patrons with systolic BP ≥ 140 mm Hg in this proof-of-concept study in which barbers promoted follow-up with pharmacists who initially met each patron in the barbershop where they prescribed BP medication under a collaborative practice agreement with the patrons’ physician. Medications were titrated during bimonthly in-person visits to achieve a BP goal of ≤130/80 mmHg. Once BP goal was reached, monthly visits were done by videoconference while barbers assisted with BP checks. Final BP and safety outcomes were assessed at 12 months. Results: After exclusion of one participant who declined adherence, 9 patients completed the intervention. Baseline BP of 155 + 14 / 83 + 11 mmHg decreased by 29 + 13 / 8.9 + 15 mmHg (p<.0001), with eight participants (89%) achieving systolic control and seven (78%) diastolic control at 12 months. These new data are statistically indistinguishable from our previous LABBPS data (p=0.8 for both change in systolic BP and diastolic BP). Overall HTN control (≤ 130/80) was 67% (6 of 9), numerically greater than the 63% observed in LABBPS (p=N.S.). As intended, the mean number of in-person pharmacist visits per patron fell from 11 in LABBPS to 6.6 visits over 12 months. No treatment-related serious adverse events occurred. Cohort retention was 90%. Conclusions: Telemedicine represents a viable substitute for in-person visits, both improving pharmacist efficiency and reducing cost while preserving intervention potency. These findings are crucial for future broad-scale implementation efforts and development of cost-effective barbershop HTN management programs for black men.