El Rio Community Health Center serves more than 75,000 people in Pima County, Arizona. In 2011, 20% of adult patients in El Rio (8,954 out of 44,952) had diagnosed high blood pressure, but only 67% of patients diagnosed had control of the disease. Pharmacists in El Rio were encouraged to set up ASAs with the Centre`s medical providers. These agreements allow pharmacists to work directly with patients to help them manage their hypertension and other chronic diseases such as diabetes and hyperlipidemia. Under the CPA, pharmacists have the ability to change medications for patients. After the implementation of CDTM, El Rio reported improved clinical outcomes (e.g. B a decrease in cholesterol and blood pressure levels), increased use of recommended tests and a reduction in emergencies. The Rio case study highlights several important considerations for the implementation of the CDM. .