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

Abstract

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.

Cardiovascular risk rate in hypertensive patients attended in primary health care units: the influence of pharmaceutical care

“…These results were shared by other studies that evaluated the effect of a pharmaceutical intervention on cardiovascular risk in other countries (Al Mazroui et al, 2009;Zhao et al, 2012;Amariles et al, 2012) and in Brazil (Lyra Junior et al, 2011;Firmino et al, 2012;Plaster, Melo, 2012;Martins, Aquino, 2013).…”

“…In turn, the "control" group showed no reduction in the systolic blood pressure. One can then infer that the pharmaceutical care was able to positively influence the reduction of systolic blood pressure values of the assisted patients/users, as inferred in previous studies (Lyra Junior et al, 2011;Firmino et al, 2012;Plaster, Melo, 2012;Zhao et al, 2012;Morgado, Rolo, Castelo-Branco, 2011).…”

“…The collecting of the patients was performed in the first four months of the period of the study (October, 2011to September, 2012.…”

Randomized Controlled Trial of Clinical Pharmacy Management of Patients with Type 2 Diabetes in an Outpatient Diabetes Clinic in Jordan

“…22 Consistent with earlier studies, the clinical pharmacy service in the present study yielded significant improvement in both systolic and diastolic blood pressure. 22,28,40 Improvement in blood pressure was also demonstrated by the significantly higher proportion of intervention patients who achieved target systolic and diastolic blood pressure values (< 130/80 mm Hg) compared with the control group at the end of the study. Since patients in both groups were prescribed similar antihypertensive medications, this finding may be due to comprehensive education of patients and the associated improvements in lifestyle behaviors and medication adherence observed in the intervention group.…”

Assessment of Knowledge, Awareness, Attitudes and HTN Outcomes in a Group of Counseled Hypertensive Patients Compared To Those Who Was Not Counseled

“…HTN nearly affects 26% of adult population worldwide. By 2025 it is projected that 29% of the world's population [1][2][3]. These studies indicate that 20% to 50% of patients do not take their medications as prescribed.…”