Pharmacist Intervention Program for Control of Hypertension

Chabot, Isabelle; Moisan, Jocelyne; Grégoire, Jean‐Pierre; Milot, Alain

doi:10.1345/aph.1c267

Cited by 124 publications

(112 citation statements)

References 18 publications

(14 reference statements)

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“…Although, this problem cannot be completely solved, there will be a cost-effective solution provided by clinical pharmacist to those patients according to their existing conditions. Some reports also indicated that pharmacist interventions were not likely to gain a statistically significant improvement in this outcome when medication adherence at baseline is already high (about 75%) (Chabot et al, 2003;Jokisalo et al, 2003), and in our study, low baseline medication adherence (47.5%) made it feasible for pharmaceutical intervention to get an obvious positive effect in this outcome and hence in treatment outcomes. And in the end, our percentage of low medication adherence accounted for 24.8%, which perfectly matched that in other studies.…”

Section: Discussionsupporting

confidence: 42%

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: Discussionsupporting

confidence: 42%

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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“…The majority have been shown to improve outcomes in hypertension, by improving adherence and reducing BP levels. Nevertheless, a study 39 showed that the impact of such a pharmacist intervention is largely conditioned by patients' income status: the low-income group did not appear to benefit from the programme. These programmes are not only effective, but also efficient: a programme, 40 which consisted in the pharmacist measuring and recording the patient's BP and assessing adherence to drug treatment each time the patient came to the pharmacy to refill his/ her antihypertensive medication, showed benefits of about 10 times higher than costs.…”

Section: Self-bp Measurementmentioning

confidence: 99%

Appraisal of the knowledge of hypertensive patients and assessment of the role of the pharmacists in the management of hypertension: results of a regional survey

Ragot

Sosner

Bouche³

et al. 2005

J Hum Hypertens

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The objectives of the study were to appraise the knowledge which the patients have about their hypertension, and to assess the knowledge and involvement of pharmacists in the management of the hypertensive patient. All the pharmacies in the Poitou-Charentes area were invited both to participate in a training session about arterial hypertension and asked to fill in a pharmacist's questionnaire. Furthermore, each participant was required to submit a patient's questionnaire to 20 consecutive hypertensives. A total of 104 pharmacies and 1015 hypertensive patients participated in the survey. In all, 88% of the patients (n ¼ 893) were aware of their blood pressure (BP) figures, but 68% (349/515) considered themselves wrongly, to be normalized; 39% (n ¼ 350) only had BP figures o140/90 mmHg. They said they had been poorly informed about recommended lifestyle changes. In all, 18% (n ¼ 185) were equipped with an automatic device. A total of 77% (n ¼ 779) were able to give the names of their drugs without the help of the pharmacist. Treatment-related unwanted effects were reported by 8% of the patients (n ¼ 79). Only 18% (n ¼ 29) of the pharmacists were able to provide a correct definition of hypertension. Most of them thought hypertension was well controlled in the general population and considered that both tolerance of and compliance with antihypertensive treatment were satisfactory. They could most often (80%, n ¼ 135) supply a SBPM device, but 58 (36%) only were able to provide relevant advice regarding the recommended procedures. In conclusion, The BP goals and the lifestyle modifications are poorly known by the hypertensives. Pharmacists' knowledge is frequently wrong and should be improved by appropriate training programmes.

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“…2 In several published studies, pharmacists have been shown to improve care for patients with cardiovascular disease, notably patients with hypertension. [3][4][5][6][7] In order to prepare students for clinical practice, colleges and schools of pharmacy are tasked with teaching about the management of hypertension as well as fostering the skill of blood pressure assessment.…”

Section: Introductionmentioning

confidence: 99%

Assessing Pharmacy Students’ Ability to Accurately Measure Blood Pressure Using a Blood Pressure Simulator Arm

Bottenberg

Bryant

Haack

et al. 2013

American Journal of Pharmaceutical Education

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Objective. To compare student accuracy in measuring normal and high blood pressures using a simulator arm. Methods. In this prospective, single-blind, study involving third-year pharmacy students, simulator arms were programmed with prespecified normal and high blood pressures. Students measured preset normal and high diastolic and systolic blood pressure using a crossover design. Results. One hundred sixteen students completed both blood pressure measurements. There was a significant difference between the accuracy of high systolic blood pressure (HSBP) measurement and normal systolic blood pressure (NSBP) measurement (mean HSBP difference 8.4 6 10.9 mmHg vs NSBP 3.6 6 6.4 mmHg; p,0.001). However, there was no difference between the accuracy of high diastolic blood pressure (HDBP) measurement and normal diastolic blood pressure (NDBP) measurement (mean HDBP difference 6.8 6 9.6 mmHg vs. mean NDBP difference 4.6 6 4.5 mmHg; p50.089). Conclusions. Pharmacy students may need additional instruction and experience with taking high blood pressure measurements to ensure they are able to accurately assess this important vital sign.

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Pharmacist Intervention Program for Control of Hypertension

Abstract: Pharmacist intervention can modify factors affecting adherence, improve adherence, and reduce BP levels in patients treated with antihypertensive agents. Impact of pharmacist intervention on BP differed according to patient income status.

Cited by 124 publications

References 18 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

Appraisal of the knowledge of hypertensive patients and assessment of the role of the pharmacists in the management of hypertension: results of a regional survey

Assessing Pharmacy Students’ Ability to Accurately Measure Blood Pressure Using a Blood Pressure Simulator Arm

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