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Implementation and evaluation of a pharmacist-led hypertension management service in primary care: outcomes and methodological challenges
Bajorek, Beata; Lemay, Kate S; Magin, Parker; Roberts, Christopher; Krass, Ines; Armour, Carol L.
Affiliation
  • Bajorek, Beata; University of Technology Sydney. Graduate School of Health - Pharmacy. Sidney. Australia
  • Lemay, Kate S; University of Sydney. Woolcock Institute of Medical Research. Glebe. Australia
  • Magin, Parker; University of Newcastle. Callaghan. Australia
  • Roberts, Christopher; Hornsby Ku-ring-Gai Hospital. Sydney Medical School - Northern. Hornsby. Australia
  • Krass, Ines; University of Sydney. Faculty of Pharmacy. Sydney. Australia
  • Armour, Carol L; University of Sydney. Sydney Local Health District. Woolcock Institute of Medical Research. Sidney. Australia
Pharm. pract. (Granada, Internet) ; 14(2): 0-0, abr.-jun. 2016. ilus, tab
Article in English | IBECS | ID: ibc-153719
Responsible library: ES1.1
Localization: BNCS
ABSTRACT

Background:

Suboptimal utilisation of pharmacotherapy, non-adherence to prescribed treatment, and a lack of monitoring all contribute to poor blood (BP) pressure control in patients with hypertension.

Objective:

The objective of this study was to evaluate the implementation of a pharmacist-led hypertension management service in terms of processes, outcomes, and methodological challenges.

Method:

A prospective, controlled study was undertaken within the Australian primary care setting. Community pharmacists were recruited to one of three study groups Group A (Control - usual care), Group B (Intervention), or Group C (Short Intervention). Pharmacists in Groups B and C delivered a service comprising screening and monitoring of BP, as well as addressing poor BP control through therapeutic adjustment and adherence strategies. Pharmacists in Group C delivered the shortened version of the service.

Results:

Significant changes to key outcome measures were observed in Group C reduction in systolic and diastolic BPs at the 3-month visit (P<0.01 and P<0.01, respectively), improvement in medication adherence scores (P=0.01), and a slight improvement in quality of life (EQ-5D-3L Index) scores (P=0.91). There were no significant changes in Group B (the full intervention), and no differences in comparison to Group A (usual care). Pharmacists fed-back that patient recruitment was a key barrier to service implementation, highlighting the methodological implications of screening.

Conclusion:

A collaborative, pharmacist-led hypertension management service can help monitor BP, improve medication adherence, and optimise therapy in a step-wise approach. However, blood pressure screening can effect behaviour change in patients, presenting methodological challenges in the evaluation of services in this context (AU)
RESUMEN
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Subject(s)

Full text: Available Collection: National databases / Spain Database: IBECS Main subject: Pharmacies / Pharmaceutical Services / Drugs for Primary Health Care / Medication Adherence / Hypertension / Interprofessional Relations Type of study: Evaluation study Aspects: Patient-preference Limits: Female / Humans / Male Language: English Journal: Pharm. pract. (Granada, Internet) Year: 2016 Document type: Article Institution/Affiliation country: Hornsby Ku-ring-Gai Hospital/Australia / University of Newcastle/Australia / University of Sydney/Australia / University of Technology Sydney/Australia

Full text: Available Collection: National databases / Spain Database: IBECS Main subject: Pharmacies / Pharmaceutical Services / Drugs for Primary Health Care / Medication Adherence / Hypertension / Interprofessional Relations Type of study: Evaluation study Aspects: Patient-preference Limits: Female / Humans / Male Language: English Journal: Pharm. pract. (Granada, Internet) Year: 2016 Document type: Article Institution/Affiliation country: Hornsby Ku-ring-Gai Hospital/Australia / University of Newcastle/Australia / University of Sydney/Australia / University of Technology Sydney/Australia
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