PSHP 2026 Residency Conference

Purpose
To evaluate the impact of a pharmacist-led intervention on inappropriate beta-blocker prescribing in adults with essential hypertension (HTN) without compelling indications
Methods
A prospective cohort study of adults with essential HTN who were prescribed a beta-blocker without a compelling indication was conducted across eight family medicine practices at our institution. A randomized convenience sample (N≈120) was identified from a prior medication use evaluation. After chart review, recommendations were sent to the primary care practitioner (PCP) to deprescribe the beta-blocker or switch to a guideline-preferred agent. Patients were excluded for resistant HTN, documented ASCVD, heart failure, recent myocardial infraction, arrhythmias, migraine, hyperthyroidism, intolerance to first-line agents, or cardiology-managed HTN. The primary endpoint was the recommendation acceptance rate. Secondary outcomes were absolute change in inappropriate beta-blocker use, time to implementation, predictors of acceptance, and documented adverse drug events. Descriptive statistics were used.
Results
A total of 25 patients met inclusion criteria. Eleven (44%) recommendations to deprescribe were accepted. Among accepted recommendations with follow-up (n = 6), 3 were implemented. Twelve (48%) recommendations were refused, and 2 (8%) received no response. The most common reason for refusal was that the beta-blocker had been initiated by a specialist (n = 11). Reported adverse drug reactions potentially related to beta-blockers (N = 26) consisted of fatigue (n = 14), bradycardia (n = 4), and sleep disturbances (n = 8). Male sex was associated with lower odds of recommendation acceptance (OR, 0.14; 95% CI, 0.02–0.84; P = 0.032).
Conclusion: to be presented at the conference