Community-focused, pharmacist-led hypertension programs in Black-owned barbershops may be a cost-effective strategy to enhance blood pressure control in Black men and significantly reduced cardiovascular risk over 10 years, according to a study published April 15 in Circulation.

Kelsey B. Bryant, MD, MPH, et al., conducted analysis of the Los Angeles Barbershop Blood Pressure Study (LABBPS), and assessed the cardiovascular health outcomes, quality-adjusted life years (QALYs), and direct health care costs over 10 years. The study evaluated Black male participants between 24 and 79 years of age with systolic blood pressure of 140 mmHg or more. To accommodate antihypertensive medication costs and travel expenses, all participants received $25 per visit with the pharmacist. Additionally, pharmacists calculated the blood pressure, fatal and non-fatal cardiovascular disease events, medication-related adverse events, and non-cardiovascular disease death in all participants.

Results showed that after 10 years, the LABBPS was a cost-effective method to manage blood pressure and reduce cardiovascular risk in Black men. The average cost per QALY gained was $42,717. If pharmacists opted for generic antihypertensive medications, they could reduce the average cost to $17,162 per QALY gained. Other variables that impacted the intervention's cost-effectiveness included medication needs and pharmacist time.

"Black-owned barbershops may be a particularly effective setting to deliver health promotion, improve hypertension control, and reduce cardiovascular disease disparities," the authors conclude. They add that "exclusive use of generic drugs could further improve the cost-effectiveness … and the feasibility for widespread implementation in the U.S."

Jae Patton, MSN, CRNP, AACC, comments in an ACC.org Journal Scan article, "It is also important to note that in the LABBPS, educating trusted community partners alone was not enough. Embedding trained cardiovascular professionals in non-traditional settings where Black men may be more comfortable receiving care was what had the biggest impact. Interventions such as the LABBPS that can reduce health inequities may be cost-effective, but improving the cardiovascular health of Black men in the U.S. carries significant non-monetary value for our society as a whole. The LABBPS challenges health care providers and systems to find innovative ways to address the legacy of systemic racism in medicine."

Clinical Topics: Cardiovascular Care Team, Prevention, Hypertension

Keywords: Antihypertensive Agents, Pharmacists, Cost-Benefit Analysis, Quality-Adjusted Life Years, Drugs, Generic, Blood Pressure, African Americans, Risk Factors, Hypertension, Blood Pressure Determination, Health Care Costs, Health Promotion, Medicine, Outcome Assessment, Health Care

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