# A Pharmacist Intervention for Monitoring and Treating Hypertension Using Bidirectional Texting

> **NIH NIH R33** · UNIVERSITY OF IOWA · 2022 · $660,049

## Abstract

ABSTRACT
Hypertension causes an estimated 395,000 deaths in the US each year: one out of every six deaths.
Hypertension is second only to smoking as a modifiable cause of death in the US. Poor blood pressure (BP)
control increases the risk of myocardial infarction, stroke and death and is often due to delays in treatment
intensification. We have developed a telehealth service called Centralized Healthcare Solutions that has
successfully delivered clinical pharmacy services remotely to private physician offices, especially in small
medical offices and rural locations. In our prior work, we demonstrated that a physician-pharmacist
collaboration could cost effectively reduce BP, but pharmacists spent a considerable proportion of their time
obtaining and aggregating patients' home BP measurements. Thus, we have developed an additional m-
health solution called What's your BP? (WyBP), a custom- built bi-directional SMS-based (short message
service, or texting) platform. WyBP is inexpensive (i.e., does not require investment in smartphone
technology, or WiFi), acceptable to a broad range of patients (including the elderly and rural populations),
scalable to subject volume observed in busy clinical settings, and easily integrated into typical clinic
workflows. In two pilots, we demonstrated a high rate of adherence, indicating that patients were willing and
able to take home BP measurements and send them to our research team. This proposal combines our two
prior efforts to use remotely located pharmacists and bi-directional texting to improve efficiencies, reduce
cost and improve access to a dedicated pharmacist. A major gap in our knowledge is whether the potency
of a “virtual” team member can be improved by home BP monitoring with technological support, especially
in small medical offices. The goal of this proposal is to evaluate whether our scalable SMS approach
combined with a pharmacist-based intervention improves BP management cost effectively. To achieve this
objective, we will determine if our intervention leads to decreases in BP; determine if our intervention leads
to intensification of therapy; and determine the cost effectiveness of the intervention. At the end of this
project, we expect to provide a novel, scalable and cost-effective approach for treating hypertension in rural
populations by expanding the feasibility, scalability and dissemination of the Centralized Healthcare
Solutions intervention. The intervention has important

## Key facts

- **NIH application ID:** 10477383
- **Project number:** 5R33HL144880-04
- **Recipient organization:** UNIVERSITY OF IOWA
- **Principal Investigator:** Barry L Carter
- **Activity code:** R33 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $660,049
- **Award type:** 5
- **Project period:** 2019-09-15 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10477383

## Citation

> US National Institutes of Health, RePORTER application 10477383, A Pharmacist Intervention for Monitoring and Treating Hypertension Using Bidirectional Texting (5R33HL144880-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10477383. Licensed CC0.

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