Impact of a Pill Box Clinic to Improve Systolic Blood Pressure in Veterans with Uncontrolled Hypertension Taking 3 or More Antihypertensive Medications

Abstract

A dvancements in the American health care system over the last 40 years have increased awareness of the effects of hypertension and appropriate antihypertensive treatment.1 Despite this increased awareness, more than 50 million Americans are estimated to still suffer from uncontrolled hypertension.

Pillbox intervention fidelity in medication adherence research: A systematic review

“…One article did not include details about whether the pillbox was provided or recommended as part of the study (Miaskowski et al, 2004). Of those studies in which a pillbox was provided, four Murray et al, 1993; prefilled the pillboxes with the participants' medications and 11 required participants to fill their own pillboxes (Ascione & Shimp, 1984;Burrelle, 1986;Huang et al, 2000;Laramee et al, 2003;Lee et al, 1999;McPherson-Baker et al, 2000;Park et al, 1992;Porter et al, 2014;Wang et al, 2010). Nochowitz et al (2009) filled pillboxes for participants if they brought their medications to the study appointment; otherwise, participants were required to fill their own.…”

“…Nochowitz et al (2009) filled pillboxes for participants if they brought their medications to the study appointment; otherwise, participants were required to fill their own. Of the 34 studies that provided pillboxes, 29 studies were designed for intervention group participants to automatically receive the pillbox as part of the intervention; these were reported in 27 articles (Ascione & Shimp, 1984;Burrelle, 1986;Calvert et al, 2012;Crome et al, 1980;Goldstein et al, 2014;Goujard et al, 2003;Huang et al, 2000;Kripalani et al, 2012;Lee et al, 1999;McPherson-Baker et al, 2000;Morales, 2009;Murray et al, 1993;Nochowitz et al, 2009;Park et al, 1992;Peterson et al, 1984;Porter et al, 2014;Schmidt et al, 2008;Tsuyuki et al, 2004;Wang et al, 2010;. In the other five studies, participants may have received a recommendation for or offered the use of a pillbox, and if they accepted the offer, they were then provided with a specific pillbox to use (Fairley et al, 2003;Kennedy, 1990;Laramee et al, 2003;Moshkovska et al, 2011;Sweeney et al, 1989).…”

“…With regard to treatment dose, there were some reports of at least one contact session that specifically covered pillbox use Goujard et al, 2003;Lee et al, 1999;Miaskowski et al, 2004;Park et al, 1992;Porter et al, 2014;Wang et al, 2010).…”

“…Interventionist Qualifications and Training. Of those studies reporting the qualifications of the interventionist, most used exclusively nurses (Bosworth et al, 2008;Crome et al, 1980;Fairley et al, 2003;Kennedy, 1990;Laramee et al, 2003;Miaskowski et al, 2004;Morales, 2009;Wang et al, 2010) (n = 9) or exclusively pharmacists (Ascione & Shimp, 1984;Calvert et al, 2012;Kripalani et al, 2012;Lee et al, 1999;McPherson-Baker et al, 2000;Murray et al, 1993;Porter et al, 2014;Sweeney et al, 1989;Taylor et al, 2003;Tsuyuki et al, 2004;Zillich et al, 2005) (n = 15), and the remaining few (n = 6) used a variety of and/or different combinations of personnel (e.g., nurses, social workers, nutritionists, physicians) (Burrelle, 1986;Goujard et al, 2003;Levensky, 2006;Moshkovska et al, 2011;Schmidt et al, 2008). Nochowicz (2009) did not specifically report interventionist qualifications, but the intervention was carried out in a pharmacistrun clinic and all investigators were pharmacists.…”

“…Delivery of the Intervention. Ten articles reported that some type of content about using the pillbox was included in the intervention, although this content varied widely Lee et al, 1999;Morales, 2009;Nochowitz et al, 2009;Park et al, 1992;Peterson et al, 1984;Porter et al, 2014;Schmidt et al, 2008;Taylor et al, 2003). For example, used pillboxes along with self-regulation counseling in which pillboxes were discussed with participants to support medication management skills such as planning and organizing of medications in routines, but no specific details were provided.…”