[74] As this is a Reviewed, Amended recommendation, the Work Group systematically reviewed evidence related to this recommendation in the evidence review conducted as part of this guideline update,[55] as well as considered evidence from the 2014 VA/DoD HTN CPG.[69-73] The Work Group s confidence in the quality of the evidence is moderate. Other considerations regarding this recommendation included the lack of data in patients under 30 years, thus the specified age range. Patient values and preferences should be compatible with keeping the higher DBP target. Thus, the Work Group decided upon a Strong for recommendation. b. General Approaches to Hypertension Management Recommendation 10. We recommend offering pharmacist-led medication management as an option for patients with hypertension. (Strong for | Reviewed, New-replaced) Discussion Pharmacist-led interventions have been effective in improving critical outcomes in hypertensive patients. Interventions which have been evaluated include medication initiation, titration and monitoring, blood pressure measurement, reminder systems, patient education regarding both medications and long-term consequences of HTN, and physician feedback. Two SRs with large effect sizes provided much of the basis for this recommendation.[75,76] In the SR of seven RCTs by Greer et al. (2016), pharmacist-led care significantly increased the proportion of patients achieving goal blood pressure of 140/90 mm Hg versus usual care over a median period of 39 weeks (risk ratio 1.45, 95% CI 1.24-1.70). Care was provided by the pharmacist either in person, remotely, or a combination of the two, and some of the included studies granted prescriptive authority.[75] The SR by Santschi et al. (2014) included 39 RCTs and compared pharmacist-led care to usual or collaborative care in over 14,000 patients with HTN. 