Outcomes of pharmaceutical care intervention to hypertensive patients in a Nigerian community pharmacy

Abstract

Objective To describe pharmaceutical care interventions provided to hypertensive patients in a Nigerian community pharmacy setting, and to assess the impact of the practice on selected patient outcomes. Method A non‐randomised, single‐site study was conducted using community‐dwelling patients with hypertension. A pharmaceutical care intervention, which consisted mainly of verbal counselling, provision of an information leaflet, and subsequent monitoring with reinforcement, was provided. Parameters assessed at baseline and end of investigation included blood pressure control, body mass index determination, level of medication adherence, patient knowledge of the disease, and patient satisfaction. Key findings Forty‐two (42) patients were recruited and 36 completed the study, 26 (73%) were males, and 33 (92%) were married. Twenty (20, 58%) had post‐secondary education. About three‐quarters (27, 81%) were either overweight or obese (BMI >25). There was a significant difference between mean systolic blood pressure at baseline (187.67 ± 29.46 mmHg) and at the end of the study (137.22 ± 21.65 mmHg), P< 0.0001. Changes in mean diastolic blood pressure at baseline (117.56 ± 21.65) and end of study (89 ± 17.23), were also significant (P< 0.0001). Some 27 (75%) reached systolic blood pressure goals while 25 (69%) attained diastolic blood pressure goals. Prior to the pharmaceutical care intervention, 27 (75%) were not aware that salt intake was a risk factor in hypertension, and a similar proportion thought that hypertension was curable. The pharmaceutical care intervention produced a significantly higher patient‐reported satisfaction rating than baseline: 3.48 ± 0.83 (49%) versus 3.92 ± 0.62 (74%); t = 2.548; P=0.013 and 3.30 ± 0.72 (41%) versus 4.27 ± 0.56 (87%); t= 6.381, P< 0.0001 on the subscales respectively. Conclusion Pharmaceutical care provided to hypertensive patients in a Nigerian community pharmacy setting improved blood pressure control and overall patient satisfaction with pharmaceutical services.

Clinical outcomes of community pharmacy services: A systematic review and meta-analysis

“…According to Krass et al (), after patients received a pharmacy diabetes care program, their HbA1c, body mass index and blood pressure were significantly reduced. Oparah, Adje, and Enato () reached a similar conclusion and stated that CPS improved blood pressure in hypertensive patients. Additionally, the education provided by community pharmacists has been shown to be greatly effective in asthma control (García‐Cárdenas et al, ).…”

Hypertensive patients' experience with adherence therapy for enhancing medication compliance: a qualitative exploration

“…, Oparah et al . , Herborg et al . ), and participation of patients in their health care (Martin et al .…”

Are interventions for improving the quality of services provided by specialized drug shops effective in sub-Saharan Africa? A systematic review of the literature

“…(2000)GhanaCBAPharmacies ( n = 100)Training staff on STIsBL-done, B-done, PC-nc, CC-done, F/U-done17Aguwa and Ukwe (2008)NigeriaCross-overPatients visiting one pharmacy ( n = 24)Training pharmacy staff on pharmaceutical careBL-done, B-nd, F/U-nc22Greer et al . (2004)NigeriaUBAPatent medicine vendors ( n = 247)Training, IEC materials, certification, public education, launch of pre-packed antimalarialsBL-done, F/U-done, B-N/A22Greer et al (2004)UgandaUBAPatent medicine vendors ( n = 138)Negotiating behaviour change for management of fever in childrenBL-done, F/U-nc, B-N/A7Mayhew et al (2001)GhanaUBAPharmacies ( n = 248)Training (1 day) on STIsBL-done, F/U-done; B-N/A16Nsimba (2007)TanzaniaRCTDrug shops ( n = 40)Training, IEC materials, control received IEC onlyAC-nc, F/U-nc, B-nc, BL-done, PC-nc23Oparah et al (2006)NigeriaUBAPatients visiting one pharmacy ( n = 36)Training pharmacy staff on pharmaceutical careBL-done, F/U-nc, B-N/A19Oshiname and Brieger (1992)NigeriaCBAPatent medicine vendors ( n = 37)Training on counselling, signs, prevention and referralBL-done, B-nd, PC-nc, F/U-nc, CC-done20Ross-Degnan et al (1996)KenyaCBAPharmacies ( n = 107)IECs and face-to-face educational outre...…”

“…of measures (No. significant at P < 0.05)Key significant outcomes18Adu-Sarkodie et al (2000)Management of STI (6–8 months)3 (3)Improvement in partner notification, counselling on condoms and proper treatment of STIs17Aguwa and Ukwe (2008)Patient compliance, blood pressure, lifestyle, knowledge and client satisfaction (5 months)15 (9)Improvement in blood pressure, lifestyle, knowledge on disease, adherence to drugs, detection of drug problems, physical health and social relationships22Greer et al (2004)Uptake of pre-packaged drugs, knowledge, communication and treatment (4 months)25 (21)Improvement in knowledge on bednets, signs and symptoms of severe childhood illness, history taking and giving correct treatment for malaria in children22Greer et al (2004)Advice on correct medicine and dose, ITN use, history taking and referral (2 months)12 (7)Improvement in recommending right drug and dose, giving instructions on how to take drugs for simple malaria, advising on ITNs and referring patients7Mayhew et al (2001)Management of STI (∼1 year)10 (not clear)Improvement in managing urethral discharge, some improvement in patient referral, little change in management of genital ulcers and related conditions16Nsimba, E (2007)Use of national treatment guidelines (6 months)10 (not clear)Improvement in providing correct treatment for diarrhoea, ARI, colds and fever23Oparah et al (2006)Patient compliance, blood pressure, knowledge and satisfaction (6 months)56 (not clear)Improvement in blood pressure, compliance scores, knowledge on hypertension and risk factors, and patient satisfaction19Oshiname and Brieger (1992)Knowledge on signs, counselling and prevention (immediate)2 (2)Pre- and post-improvement in overall questionnaire score in the intervention arm; post-training improvement in intervention arm significant compared to control20…”