Implementation and evaluation of a pharmacist-led hypertension management service in primary care: outcomes and methodological challenges

Bajorek, Beata; LeMay, Kate; Magin, Parker; Roberts, Chris; Krass, Ines; Armour, Carol

doi:10.18549/pharmpract.2016.02.723

Cited by 29 publications

(35 citation statements)

References 34 publications

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“…Medication adherence practices are well promoted with focused group discussions. [31][32][33][34][35][36][37][38][39] Confidentiality and privacy should be maintained at all times during focused group discussions. Discussion between patients observed to be very fruitful.…”

Section: Focused Group Discussionmentioning

confidence: 99%

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Strengthening Medication Adherence Practices in Chronic Disease Patients-clinical Pharmacist Driven Focused Approach

Wadhwa¹,

Jalal²,

Merghani³

et al. 2019

IJOPP

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Medication adherence practices are becoming an important concern for healthcare professionals and patients. Globally, medication non-adherence is quite prevalent and affecting the healthcare of patients leading to inadequate response to treatment and augmented healthcare cost. With the advent of improvised practices in clinical care, patient-related problems mainly non-adherence have been conquered to a greater extent. Clinical practice is changing over a period contributing more towards patient care. Expansion of clinical pharmacy activities with a focused approach towards patient care especially optimized pharmaceutical care has seen a tremendous revolution in modern era. According to a study, 50% of patients with chronic conditions are not adherent to their medications with an estimated adherence range of 17% to 80%. Drugs used for asymptomatic chronic conditions have been shown to have low adherence rates. Risk of non-adherence has been shown to be rapidly increasing with the initiation of chronic medication especially in the first year of its commencement. Medication nonadherence is one of the most significant reason for inadequate response to drug therapy, initial hospitalization, frequent hospital visits and Adverse Drug Events (ADEs) leading to inappropriate therapeutic outcome and in turn, raised healthcare cost. Due to lack of sufficient support or appropriate channel, there is a growing concern for healthcare professionals to take initiative and strengthen the medication adherence practices. Clinical pharmacist's initiatives in this direction has been appreciated and documented with clinically proven evidence of better impact on patient's health-related quality of life. Patient tools such as pill reminders, alarming system, dose indicator, standard day-wise schedule, colorful pills etc. have brought pill revolution with the intention of improvising medication adherence practices worldwide. The current requirement is to monitor such patients in clinical practice and encourage them to comply with medication-related instructions and adhere to their medication schedule at the most.

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Section: Focused Group Discussionmentioning

confidence: 99%

“…Physical verification of tablets/capsules in presence of healthcare professionals will certainly improve the understanding of the patient. [26][27][28][29][30][31][32][33][34][35][36][37][38]…”

Section: Train Patients In Clinics/hospitals For Medicine Consumptionmentioning

confidence: 99%

Strengthening Medication Adherence Practices in Chronic Disease Patients-clinical Pharmacist Driven Focused Approach

Wadhwa¹,

Jalal²,

Merghani³

et al. 2019

IJOPP

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“…Pharmacist prescribing for patients with hypertension and diabetes mellitus was agreed upon by seven of the nine expert panel members and by 27 of the 31 hospital pharmacists who participated in the study. Collaborative pharmacist‐led management services in hypertension and diabetes mellitus can help to improve monitoring and control of blood pressure and blood glucose, CVD risk factors, medication adherence and optimise therapy …”

Section: Discussionmentioning

confidence: 99%

“…Collaborative pharmacist-led management services in hypertension and diabetes mellitus can help to improve monitoring and control of blood pressure and blood glucose, CVD risk factors, medication adherence and optimise therapy. [3,11,36,37] Results of the case studies showed that pharmacists and physicians prescribed similar treatment when the correct diagnosis was established. The case studies were selected as examples to demonstrate the ability of appropriate diagnosis by pharmacists even for 'atypical' cases.…”

Section: Discussionmentioning

confidence: 99%

Preparing for pharmacist prescribing in Maltese hospitals

Aquilina

Wirth

Pizzuto

et al. 2018

J Pharm Health Serv Res

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Objectives To develop and evaluate a framework for pharmacist prescribing in a hospital setting, assess differences between pharmacist and physician prescribing and analyse pharmacist perceptions on pharmacist prescribing. Methods A framework for pharmacist prescribing in hospital based on a collaborative drug therapy management approach was developed. Guidelines on three therapeutic scenarios, namely oral anticoagulation therapy, hypertension and diabetes mellitus, were compiled as part of the framework. The framework was validated by an expert panel consisting of five pharmacists and four physicians. A self‐administered questionnaire was developed and distributed to the expert panel to evaluate the framework. A case study relating to each therapeutic scenario identified was designed and given to the expert panel to assess differences between pharmacist and physician prescribing. The framework and the questionnaire were disseminated to all 62 pharmacists practicing in local public hospitals to evaluate the framework and their perceptions on pharmacist prescribing. Key findings All nine expert panel members strongly agreed or agreed that the proposed framework is well‐presented, clear and comprehensive, and seven strongly agreed or agreed upon its practicality for use in the hospital setting. Results of the case studies showed that pharmacists and physicians prescribed similar treatment when the correct diagnosis was established. Of the 31 pharmacists who completed the questionnaire, more pharmacists were willing to prescribe antihypertensive (n = 27) and antidiabetic medications (n = 27) compared to oral anticoagulation therapy (n = 20). Twenty‐seven pharmacists recommended further education to a specialised Masters or Doctorate level for pharmacist prescribing. Conclusions The proposed framework puts forward a well‐presented, comprehensive and practical system to prepare pharmacists for pharmacist prescribing in a hospital setting within a multidisciplinary team practice for chronic conditions.

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“…12 Recently, several health education programs have been initiated to improve blood pressure control in the community 13 and patients' knowledge on a disease and therapy, 14 including pharmacist led intervention in lifestyle changes and medication adherence among hypertensive patients. [15][16][17] A meta-analysis study showed that pharmacist led intervention was associated with significant reductions in systolic blood pressure [11 studies (2240 patients); −6.1 mmHg (95% confidence interval, −3.8 to−8.4 mmHg); P<0.00001]. 18 In addition, previous studies have demonstrated pharmacist led interventions can rationalise medication use in patients 19,20 and taking more positive role in patient self-management.…”

Section: Introductionmentioning

confidence: 99%

The Role of Pharmacist in Managing Hypertension in the Community: Findings from a Community Based Study

Tan¹,

Hassali²,

Fen³

2019

IJPER

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Introduction: Pharmacist led health education programs have been initiated to improve Blood Pressure (BP) control in the community and patients' knowledge on a disease and therapy, lifestyle changes and medication adherence among hypertensive patients. This study aimed to evaluate pharmacist led health education program among hypertensive patients, in local community-based setting, by assessing the changes in blood pressure control, beliefs about medicine, antihypertensive medications adherence and quality use of medication. Methods: This study was prospective convenient sampling, with communitybased health education study involving 45 participants at the Community Service Hall in Bukit Mertajam, Penang, Malaysia. Participants received health education program over 4 months period: Introduction of hypertension, pharmacological management of hypertension, quality use of medication and diet and lifestyle changes. Outcomes included the changes Blood Pressure (BP) level, Malaysian Medication Adherence Assessment (MALMAS), Beliefs about Medicines Questionnaire (BMQ) and Quality Use of Medication (QUM). Results: Both systolic BP (146.6 ± 11.1 mmHg, P<0.001) and diastolic BP (87.6 ± 9.6 mmHg, P=0.002) decreased significantly after the 2-months intervention. Systolic BP was successfully reduced significantly to 140.1 ± 10.7 mmHg (P<0.001) after the 4-months intervention. Medication adherents increased significantly from baseline (29.3%) to 2-months interventions (58.5%, P=0.005) and 4-months interventions (70.7%, P<0.001). Significant improvement was also noticed in BMQ and QUM. Conclusion: Pharmacist led health education program has significantly desirable effects on improvement of blood pressure, better beliefs about medicine, improvement of medication adherence and better rational use of medication

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Implementation and evaluation of a pharmacist-led hypertension management service in primary care: outcomes and methodological challenges

Cited by 29 publications

References 34 publications

Strengthening Medication Adherence Practices in Chronic Disease Patients-clinical Pharmacist Driven Focused Approach

Strengthening Medication Adherence Practices in Chronic Disease Patients-clinical Pharmacist Driven Focused Approach

Preparing for pharmacist prescribing in Maltese hospitals

The Role of Pharmacist in Managing Hypertension in the Community: Findings from a Community Based Study

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