Evaluation of a pharmaceutical care program for hypertensive patients in rural Portugal.
OBJECTIVE
To evaluate the community pharmacist's capacity to positively influence the results of antihypertensive drug therapy through a pharmaceutical care program and to determine what factors limit the program.


METHODS
Randomized, controlled study.


METHODS
Private pharmacy caring for a semiliterate, rural Portuguese population.


METHODS
Random sample of 100 patients with a diagnosis of essential hypertension who had been on drug treatment for less than 6 months. Patients were randomly assigned to an intervention (n = 50) or a control (n = 50) group.


METHODS
Individualized health promotion by a research pharmacist involving monthly appointments for 6 months to monitor blood pressure; assess adherence to treatment; prevent, detect, and resolve drug-related problems (DRPs); and encourage nonpharmacologic measures for blood pressure control. Control patients received traditional care.


METHODS
Control of blood pressure; decreases in systolic/diastolic blood pressure; number of detected, resolved, and prevented DRPs.


RESULTS
From the initial sample of 100 patients, 41 patients in the intervention group and 41 patients in the control group completed the longitudinal study. After 6 months, prevalence of uncontrolled blood pressure decreased by 77.4% in the intervention group (P < .0001) and by 10.3% in the control group (P = .48). Systolic blood pressure fell from a mean +/- standard deviation of 152 mm Hg +/- 23 mm Hg to 129 +/- 15 mm Hg in intervention patients and 148 +/- 16 mm Hg to 143 +/- 20 mm Hg in control patients (P < .001). Twenty-four of 29 (83%) detected actual DRPs were resolved. About 40% of potential DRPs were prevented.


CONCLUSIONS
In this rural community, a pharmaceutical care program was associated with significant improvements in blood pressure control in hypertensive patients.
Garção
Jové A
JA
Public Health Department, Faculty of Pharmacy, University of Lisbon, Portugal. garcao@mail.telepac.pt
Cabrita
José
J
D000368:Aged; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010593:Pharmaceutical Services; D010594:Pharmacies; D011174:Portugal; D012424:Rural Population; D016896:Treatment Outcome
D000959:Antihypertensive Agents