In this sample of treated hypertensive patients, the agreement between the community pharmacy and HBP measurement methods was acceptable-moderate and greater than other agreements. The CPBP measurement method was more reliable than the POBP measurement method for detecting the presence of both uncontrolled and controlled BP and could be a good alternative to HBP monitoring when the latter lacks suitability.

The aim of this study was to measure the community pharmacy white-coat effect (CPWCE) in treated hypertensive patients and to compare its magnitude with the WCE in the physician's office (POWCE). This cross-sectional study attempted to cover the treated hypertensive population, of more than 18 years of age and users of a rural CP located in Palmera (Valencia, Spain). Blood pressure (BP) was measured at three different settings, according to clinical guidelines: CP (three visits), PO (three visits), and home (4 consecutive days). The WCE was defined as the difference between the average CPBP or the average PO BP and the average home BP: CPWCE and POWCE, respectively. Differences between BP measurements were assessed by paired t-tests. The study sample consisted of 70 patients. The CPWCE was not significant, both for systolic BP (SBP) and for diastolic BP (DBP): 1.4 mmHg [standard deviation (SD): 11.3; 95% confidence interval (CI): -1.3 to 4.1] and -1.1 mmHg (SD: 7.5; 95% CI: -2.9 to 0.7), respectively. The POWCE was positive and statistically greater than 0 for SBP [13.3 mmHg (SD: 11.5); 95% CI: 10.5-16.0] and for DBP [2.4 mmHg (SD: 9.3); 95% CI: 0.2-4.6]. Finally, the POWCE was greater than the CPWCE both for SBP and for DBP (P<0.001). In this sample of treated hypertensive patients, the CPWCE was not statistically significant and was statistically lower than the POWCE.

Dementia is a neurodegenerative disease with no cure that can begin up to 20 years before its diagnosis. A key priority in patients with dementia is the identification of early modifiable factors that can slow the progression of the disease. Community pharmacies are suitable points for cognitive-impairment screening because of their proximity to patients. Therefore, the continuous training of professionals working in pharmacies directly impacts the public health of the population. The main purpose of this study was to assess community pharmacists’ knowledge of dementia-related factors. Thus, we conducted a cross-sectional study of 361 pharmacists via an online questionnaire that quizzed their knowledge of a list of dementia-related factors, which we later arranged into the A-to-Z Dementia Knowledge List. We found that younger participants had a better knowledge of risk factors associated with dementia. The risk factors most often identified were a family history of dementia followed by social isolation. More than 40% of the respondents did not identify herpes labialis, sleep more than 9 h per day, and poor hearing as risk factors. A higher percentage of respondents were better able to identify protective factors than risk factors. The least known protective factors were internet use, avoidance of pollution, and the use of anti-inflammatory drugs. Pharmacists’ knowledge of dementia-related factors should be renewed with the aim of enhancing their unique placement to easily implement cognitive-impairment screening.

F or decades, blood pressure (BP) measurement at a physician's office has been considered the cornerstone in the diagnosis and management of hypertension. However, BP measurement by a physician may induce an alerting reaction in the patient, which is manifest by a transient increase in BP, usually called the "white-coat effect" (WCE).1 WCE could possibly impair the appropriateness of clinical evaluations and decision making (e.g., overdiagnosis, underestimate of effectiveness, use of unnecessary medication).It is important to differentiate between the WCE (isolated increase in BP, expressed in millimeters mercury [mm Hg]) and white-coat hypertension (WCH), defined as a condition in which office BP is persistently elevated (equal to or greater than 140/90 mm Hg), while out-of-office BP is within the normal range (less than 135/85 mm Hg). Thus, the WCE and WCH are different entities.The problem of the WCE can be overcome with the use of out-of-office BP measurements, such as either ambulatory BP monitoring (ABPM) or home BP monitoring (HBPM). 2Compared with BP measurement at a physician's office, both ABPM and HBPM provide a greater number of BP readings in more realistic circumstances and may lead to an improved assessment of patients' ''true'' BP levels. Additionally, these approaches show a better correlation with target organ damage (e.g., carotid atherosclerosis) and better predict cardiovascular events, such as nonfatal myocardial infarction, nonfatal stroke, or death.3-5 Moreover, the ABPM register provides extensive information on several BP parameters, including average BP (daytime, nighttime, 24 hours), BP variability, morning BP surge, or nocturnal fall in BP, among others. For these reasons, ABPM, as the reference, and HBPM, as a complement, are currently considered valuable methods in the diagnosis and management of hypertension. 2,[6][7][8][9] Despite its usefulness, ABPM is not available for the entire hypertensive population. On the other hand, although HBPM is cheaper and more widely available than ABPM, this method may not be recommended in some situations, such as learning disability, risk of anxiety and excessive monitoring, risk of treatment changes without doctor's guidance, or questionable reliability of BP values reported by patients. In these cases, it would be desirable to have an alternative that can provide valuable information for clinical decision making.Theoretically, BP measurement by community pharmacists presents certain key advantages, making it of particular interest. These advantages include (a) the availability of multiple BP readings due to the accessibility of the pharmacy and (b) the presence of a health care professional, who can select appropriate (clinically validated) measurement devices and supervise the measurement conditions. Moreover, patients commonly check BP at community pharmacies, 10 and taking BP measurements in this setting is recommended by some scientific hypertension societies, such as those in Canada (Canadian Hypertension Education Program Implementation...