Optimizing Hypertension Control in CKD Through Collaborative Pharmacist Interventions

Abstract

Hypertension is a major contributor to kidney and cardiovascular morbidity and mortality in chronic kidney disease (CKD) yet achieving blood pressure (BP) control remains challenging. Team-based care, particularly involving clinical pharmacists, has demonstrated effectiveness in the management of hypertension with the bulk of the evidence in non-CKD populations. In this article, we review the evidence evaluating pharmacist-led interventions in BP management generally and in CKD. Notably, pharmacist-led interventions that have integrated clinical pharmacists into care teams with medication management capabilities showed the greatest promise for improving BP control. In contrast, studies that implemented models relying on asynchronous recommendations often failed to achieve significant BP reductions. Common barriers to pharmacist-led interventions in CKD include workflow integration, resource constraints, and limited reimbursement pathways despite the evidence indicating high acceptance of pharmacist-led interventions from patients. Additional research is needed to evaluate the effectiveness of pharmacist-led interventions in CKD and to identify sustainable and scalable implementation strategies for pharmacist integration to improve BP control in CKD.