Improving Blood Pressure Control in a Pharmacist‐Managed Hypertension Clinic

Vivian, Eva

doi:10.1592/phco.22.17.1533.34127

Cited by 155 publications

(145 citation statements)

References 17 publications

(13 reference statements)

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“…According to the data in Table 4, all items in CG were improved when compared with themselves six months ago, although, very obviously less than that in IG. Since, the two groups benefited from the same status quo of our social progress, respectively, an additional improvement in IG should be mainly attributed to the interventions of pharmacist with expertise and experience in drug therapy and participation in our outpatient clinic (Vivian, 2002). In our study, pharmacist conducted a total number of 192 medicative recommendations for drug therapy in IG, in which "Added a new antihypertensive drug" and "Increased dose" were the most frequent practice, accounting for 82 (42.7%) and 51 (26.6%).…”

Section: Discussionmentioning

confidence: 99%

Effect of clinical pharmacists pharmaceutical care intervention to control hypertensive outpatients in China

Zhao¹,

Wang²,

Qin³

et al. 2012

Afr. J. Pharm. Pharmacol.

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Hypertension is an increasingly common health problem that affects more than 1 billion people throughout the world. Antihypertensive drugs are the current pharmacotherapy of choice, however uncontrolled blood pressure (BP) accounts for 7.1 million deaths worldwide each year. Little is known about the efficacy of clinical pharmacist's pharmaceutical care on BP control and medication adherence. The aim of this study was to describe if pharmaceutical care could improve antihypertensive medication adherence and BP control, especially by clinical pharmacists recommendations. This report evaluates the clinical pharmacist interventions during a prospective randomized controlled trial. Out patients with essential hypertension were enrolled in a bimestrial follow-up during 6-month period study; patients were randomly allocated either intervention group (IG) or to control group (CG). Pharmacist interventions involved recommendations to physicians, educational and counseling directly to the patient. The main outcome measure for this analysis was the measure of systolic blood pressure (SBP), diastolic blood pressure (DBP), BP control and medication adherence using a validated questionnaire assessed at the baseline visit and the end of pharmaceutical care. Data from 278 patients were included and analyzed (139 in CG and 139 in IG). There were no significant differences (P < 0.05) in both groups at the baseline. Changes in drug therapy were recommended 192 times for IG patients, the majority of these, involved adding a new antihypertensive drug (42.7%); the largest numbers of pharmacist recommendations (39.6%) were made at the baseline visit. At the end, BP was controlled among significant patients more in IG (76.4%) than in CG (50.6%) (P = 0.0000). Significant lower SBP (-8.5 mmHg, P = 0.0001) and DBP (-4.7 mmHg, P = 0.0013) levels were observed in IG. Low medication adherence, there was also significantly difference between two groups at the end (24.8% versus 41.7%, P = 0.0014). Clinical pharmacist recommendations for alterations in pharmacotherapy intervention can significantly improve medication adherence and BP control in patients with hypertension. Clinical pharmacist recommendations can complement physicians in the management of hypertensive patients. Pharmacist interventions are effective in improving anti-hypertensive medication adherence and reducing systolic and diastolic blood pressure. Pharmacists can effectively participate in health education and promotion to improve blood pressure control.

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Section: Discussionmentioning

confidence: 99%

Effect of clinical pharmacists pharmaceutical care intervention to control hypertensive outpatients in China

Zhao¹,

Wang²,

Qin³

et al. 2012

Afr. J. Pharm. Pharmacol.

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“…Other studies showed the positive results of interventions, leading to the solution and prevention of DTP, reduction of treatment costs and satisfaction with Pharmaceutical Care program (Lee et al, 2006;Lyra Jr. et al, 2005;Vivian, 2002, Bernsten et al, 2001.…”

Section: Evaluation Of Pharmaceutical Care Interventionmentioning

confidence: 99%

“…In other countries, previous research have shown that pharmacist involvement in the ambulatorial care of hypertensive patients improves BP control (Lee et al, 2006;Zillich et al, 2005;Vivian, 2002;Mehos et al, 2000). Although, primary care units are the entrance of SUS, it almost does not have studies published about Pharmaceutical Care practice in Brazil (Lyra Jr. et al, 2007;Souza et al, 2007;Castro et al, 2006;Lyra Jr. et al, 2005;Oliveira et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Effect of pharmaceutical care intervention on blood pressure of elderly outpatients with hypertension

Júnior¹,

Marcellini²,

Pelá³

2008

Rev. Bras. Cienc. Farm.

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“…Randomized clinical trials have demonstrated that non-physician clinicians are more effective at bringing hypertensive individuals in concordance with national guideline goals (41)(42)(43)(44)(45). One mechanism for the success of nurses in improving BP control relates to their training to address non-pharmacological interventions.…”

Section: Theoretical Frameworkmentioning

confidence: 99%

Take Control of Your Blood pressure (TCYB) study: A multifactorial tailored behavioral and educational intervention for achieving blood pressure control

Bosworth

Olsen

Neary

et al. 2008

Patient Education and Counseling

140

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Objectives-Evaluating a randomized controlled trial involving a tailored behavioral intervention conducted to improve blood pressure control.Methods-Adults with hypertension from two outpatient primary care clinics were randomly allocated to receive a nurse-administered behavioral intervention or usual care. In this ongoing study, patients receive the tailored behavioral intervention bi-monthly for two years via telephone; the goal of the intervention is to promote medication adherence and improve hypertension-related health behaviors. Patient factors targeted in the tailored behavioral intervention include perceived risk of hypertension and knowledge, memory, medical and social support, patients' relationship with their health care provider, adverse effects of medication therapy, weight management, exercise, diet, stress, smoking, and alcohol use.Results-The sample randomized to the behavioral intervention consisted of 319 adults with hypertension (average age = 60.5 years; 47% African-American). A comparable sample of adults was assigned to usual care (n=317). We had a 96% retention rate for the overall sample for the first 6 months of the study (93% at 12 months). The average phone call has lasted 18 minutes (range 2 to 51 minutes). From baseline to six months, self-reported medication adherence increased by 9% in the behavioral group vs. 1% in the non-behavioral group.Conclusion-The intervention is easily implemented and is designed to enhance adherence with prescribed hypertension regimen. The study includes both general and patient-tailored information based upon need assessment. The study design ensures internal validity as well as the ability to generalize study findings to the clinic settings. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Practice Implications-Despite knowledge of the risks and acceptable evidence, a large number of hypertensive adults still do not have their blood pressure under effective control. This study will be an important step in evaluating a tailored multibehavioral intervention focusing on improving blood pressure control. NIH Public Access

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Improving Blood Pressure Control in a Pharmacist‐Managed Hypertension Clinic

Abstract: Pharmaceutical care improves blood pressure control and results in more patients with hypertension reaching their blood pressure goal.

Cited by 155 publications

References 17 publications

Effect of clinical pharmacists pharmaceutical care intervention to control hypertensive outpatients in China

Effect of clinical pharmacists pharmaceutical care intervention to control hypertensive outpatients in China

Effect of pharmaceutical care intervention on blood pressure of elderly outpatients with hypertension

Take Control of Your Blood pressure (TCYB) study: A multifactorial tailored behavioral and educational intervention for achieving blood pressure control

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