Pharmacist involvement in the patient care improves outcome in hypertension patients

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Abstract

Objective:

The main objective of this study was to assess the effects of pharmaceutical care interventions in patients with essential hypertension in Lakshmi Pat Singhania Institute of Cardiology, Kanpur, India.

Methods:

The study was carried out from July 2010 to August 2011. Pharmaceutical care was provided for 54 patients (intervention group) which was comprised of the patient education, the prescription assistance and the life style modifications and motivation for health. Then the clinical outcome as well as health related quality of life (HRQOL) were compared with the control group (48 patients) in which the pharmaceutical care was not provided. Furthermore, the effect of pharmaceutical care intervention on HRQOL was assessed using Short Form-36 (SF-36), a general health related quality of life questionnaire used to evaluate the QOL of patients. Blood pressure (BP) measurements and QOL survey was performed at baseline and at the follow-up session.

Findings:

The difference between blood pressure readings from the baseline to the second follow-up was significant for systolic [( P = 0.0001), 12.24 mmHg] and diastolic BP [( P = 0.001), 5.17 mmHg] in the intervention group. The questionnaire used to evaluate the QOL of patients also showed improvement in the mean score for intervention group.

Conclusion:

Results from our study showed that applying pharmaceutical care to hypertensive patients can help in the control of these patients’ blood pressure, and consequently lower the risk that hypertension poses in cardiovascular disease. Successful implementation of pharmaceutical care has the potential to increase patients’ satisfaction with their pharmacists’ activities and may increase patients’ expectations that pharmacists will work on their behalf to assist them with their healthcare needs.

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Most cited references 19

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Effects of diet and sodium intake on blood pressure: subgroup analysis of the DASH-sodium trial.

William M Vollmer, Frank Sacks, Jamy Ard … (2001)

Initial findings from the Dietary Approaches to Stop Hypertension (DASH)-Sodium Trial demonstrated that reduction of sodium intake in two different diets decreased blood pressure in participants with and without hypertension. To determine effects on blood pressure of reduced sodium intake and the DASH diet in additional subgroups. Randomized feeding study. Four clinical centers and a coordinating center. 412 adults with untreated systolic blood pressure of 120 to 160 mm Hg and diastolic blood pressure of 80 to 95 mm Hg. Participants followed the DASH diet or a control (typical U.S.) diet for three consecutive 30-day feeding periods, during which sodium intake (50, 100, and 150 mmol/d at 2100 kcal) varied according to a randomly assigned sequence. Body weight was maintained. Systolic and diastolic blood pressure. In all subgroups, the DASH diet and reduced sodium intake were each associated with significant decreases in blood pressure; these two factors combined produced the greatest reductions. Among nonhypertensive participants who received the control diet, lower (vs. higher) sodium intake decreased blood pressure by 7.0/3.8 mm Hg in those older than 45 years of age (P < 0.001) and by 3.7/1.5 mm Hg in those 45 years of age or younger (P < 0.05). The DASH diet plus reduced sodium intake is recommended to control blood pressure in diverse subgroups.

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Change in body mass index and its impact on blood pressure: a prospective population study.

K Midthjell, Tom I L Nilsen, W Drøyvold … (2005)

Overweight and obesity increase the risk of elevated blood pressure, but the knowledge of the effect of weight change on blood pressure is sparse. To investigate the association between change in body mass index (BMI) and change in diastolic blood pressure (DBP), systolic blood pressure (SBP), and hypertension status. Two population-based cross-sectional studies, one in 1984-86 and the other in 1995-97. The Nord-Trondelag Health Study (HUNT). We included 15,971 women and 13,846 men who were 20 y or older at the first survey, without blood pressure medication at both surveys and without diabetes, cardiovascular disease or dysfunction in daily life at baseline. Weight, height and blood pressure were measured standardised. Change in BMI was categorised as stable (initial BMI+/-0.1 kg/m2 each follow-up year), increased or decreased, and BMI was categorised by using World Health Organisation's categorisation (underweight BMI: or =30 kg/m2). An increase in BMI and a decrease in BMI were significantly associated with increased and decreased SBP and DBP, respectively, compared to a stable BMI in both genders and all age groups, although the strongest effect was found among those who were 50 y and older. The adjusted odds ratio for having hypertension at HUNT 2 was 1.8 (95% confidence interval (CI): 1.5, 2.2) among women and 1.6 (95% CI: 1.4,1.8) among men aged 20-49 y who increased their BMI compared to those who had stable BMI. A similar, but weaker association was found among women and men aged 50 y or more. The mean change in both SBP and DBP was higher for those who changed BMI category from first to the second survey than for those who were in the same BMI class at both surveys. Our result supports an independent effect of change in BMI on change in SBP and DBP in both women and men, and that people who increase their BMI are at increased risk for hypertension.

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Effect of pharmacist intervention and initiation of home blood pressure monitoring in patients with uncontrolled hypertension.

E MacLaughlin, Joseph J Saseen, B Mehos (2000)

This prospective, randomized, controlled study evaluated the impact of pharmacist-initiated home blood pressure monitoring and intervention on blood pressure control, therapy compliance, and quality of life (QOL). Subjects were 36 patients with uncontrolled stage 1 or 2 hypertension. Eighteen subjects received home blood pressure monitors, a diary, and instructions to measure blood pressure twice every morning. Home measurements were evaluated by a clinical pharmacist by telephone, and the patient's family physician was contacted with recommendations if mean monthly values were 140/90 mm Hg or higher. Eighteen control patients did not receive home monitors or pharmacist intervention. Office blood pressure measurements and QOL surveys (SF-36) were obtained at baseline and after 6 months. Mean absolute reductions in systolic and diastolic pressures were significantly reduced from baseline in intervention subjects (17.0 and 10.5 mm Hg, both p < 0.0001) but not in controls (7.0 and 3.8 mm Hg, p = 0.12 and p = 0.09). More intervention subjects (8) had blood pressure values below 140/90 at 6 months compared with controls (4). During the study 83.3% (15) of intervention subjects had drug therapy changes versus 33% (6) of controls (p < 0.01). Compliance and QOL were not significantly affected. Our data suggest that the combination of pharmacist intervention with home monitoring can improve blood pressure control in patients with uncontrolled hypertension. This may be related to increased modifications of drug regimens.

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Author and article information

Journal

Journal ID (nlm-ta): J Res Pharm Pract

Journal ID (iso-abbrev): J Res Pharm Pract

Journal ID (publisher-id): JRPP

Title: Journal of Research in Pharmacy Practice

Publisher: Medknow Publications & Media Pvt Ltd (India )

ISSN (Print): 2319-9644

ISSN (Electronic): 2279-042X

Publication date (Print): Jul-Sep 2013

Volume: 2

Issue: 3

Pages: 123-129

Affiliations

[1 ]Department of Pharmacy, Jodhpur National University, Jodhpur, Rajasthan, India

[2 ]Department of Pharmacy, Pranveer Singh Institute of Technology, Bhauti Road, Kanpur, Uttar Pradesh, India

[3 ]Department of Medicine, LPS (Lakshmi Pat Singhania) Institute of Cardiology, Kanpur, Uttar Pradesh, India

Author notes

Corresponding author: Mr. Pranay Wal, E-mail: pranaywal@ 123456gmail.com

Article

Publisher ID: JRPP-2-123

DOI: 10.4103/2279-042X.122386

PMC ID: 4076915

SO-VID: c7886fd4-f05c-46f9-84cd-783ebb2d5d80

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Pharmacist involvement in the patient care improves outcome in hypertension patients

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Abstract

Objective:

Methods:

Findings:

Conclusion:

Related collections

Asian Journal of Quality of Life (AjQoL)

Most cited references 19

Effects of diet and sodium intake on blood pressure: subgroup analysis of the DASH-sodium trial.

Change in body mass index and its impact on blood pressure: a prospective population study.

Effect of pharmacist intervention and initiation of home blood pressure monitoring in patients with uncontrolled hypertension.

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