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Advisor(s)
Abstract(s)
Objective Studies have demonstrated that
hypertension remains inadequately managed throughout
the world, with lack of adherence to BP-lowering medication
being a major factor. The aim of the present study
was to evaluate if a pharmaceutical care program could
improve antihypertensive medication adherence and blood
pressure control. Setting This study was conducted in a
secondary care hypertension/dyslipidemia outpatient clinic
in the university teaching hospital of Cova da Beira Hospital
Centre, Covilha˜, located in the Eastern Central Region
of Portugal. Method This report evaluates the pharmacist’s
interventions during a prospective randomised controlled
trial, from July 2009 to June 2010. Patients with diagnosis
of essential hypertension attending the clinic for routine
follow-up were randomly allocated either to a control
group (no pharmaceutical care) or to an intervention group
(quarterly follow-up by a hospital pharmacist during a 9-
month period). The pharmacist interventions, aimed to
increase medication adherence and blood pressure control,
involved educational interventions and counselling tips
directed to the patient. Main outcome measure Systolic
blood pressure, diastolic blood pressure and blood pressure
control (according to JNC 7 guidelines) assessed at the
baseline visit and at the end of pharmaceutical care were
the main outcome measures. Blood pressure measurements were performed by blinded nurses. Medication adherence
was also evaluated, using a validated questionnaire at
baseline and at the end of investigation. Results A total of
197 hypertensive patients were randomly assigned to the
study (99 in the control group and 98 in the intervention
group). Although there were no significant differences
(P[0.05) in both groups concerning mean age, gender,
body mass index, and antihypertensive pharmacotherapy,
blood pressure control was higher in the intervention group
(P = 0.005) at the end of the study. Significant lower
systolic blood pressure (-6.8 mmHg, P = 0.006) and
diastolic blood pressure (-2.9 mmHg, P = 0.020) levels
were observed in the intervention group. Medication
adherence was also significantly higher in the intervention
group at the end of the study (74.5% vs. 57.6%,
P = 0.012).Conclusion Pharmacist intervention can significantly
improve medication adherence and blood pressure
control in patients treated with antihypertensive
agents.
Description
Keywords
Blood pressure Clinical trial Hospital pharmacist Hypertension Medication adherence Pharmaceutical care Pharmacist intervention Portugal
Citation
Int J Clin Pharm (2011) 33:132–140