Pharmacist involvement in primary care improves hypertensive patient clinical outcomes.
BACKGROUND
The practice of pharmaceutical care in primary care settings in Thailand is currently not generally accepted.


OBJECTIVE
To evaluate the effect of pharmacist involvement in treatment with hypertensive patients in primary care settings.


METHODS
The treatment objective was to stabilize the blood pressure (BP) of hypertensive patients in accordance with the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure guidelines. Patients were randomly assigned to a pharmacist-involved group (treatment) or a group with no pharmacist involvement (control). Pre- and post-test BPs, tablet counts, lifestyle modifications, and pharmacists' recommendations were recorded. The 6-month study was carried out in Mahasarakham University pharmacy and 2 primary care units. Patients were monitored monthly by reviewing their medications and supported by providing pharmaceutical care and counseling.


RESULTS
From a total of 235 patients, the treatment group (n = 118) had a significant reduction in both systolic (S) and diastolic (D) BP compared with the 117 patients of the control group (p = 0.037, 0.027, respectively). The 158 patients (76 treatment, 82 control) with BPs >or=140/90 mm Hg at the beginning of the study showed significant BP reductions (p = 0.002 SBP, 0.008 DBP). The proportion of 158 patients whose BP became stabilized was higher in the treatment group (p = 0.017). The treatment group showed significantly better adherence (p = 0.014) and exercise control (p = 0.012) at the end of the study. Physicians accepted 42.72% of medication modifications and 5.34% of the suggestions for additional investigations.


CONCLUSIONS
Hypertensive patients who received pharmacist input achieved a significantly greater benefit in BP reduction, BP control, and improvement in adherence rate and lifestyle modification.
Sookaneknun
Phayom
P
Faculty of Pharmacy, Chiang Mai University, Chiang Mai Province, Thailand. psookane@yahoo.com
Richards
Robert M E
RM
Sanguansermsri
Jaratbhan
J
Teerasut
Chai
C
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003157:Community Pharmacy Services / Q000458:organization & administration; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D005791:Patient Care; D010349:Patient Compliance; D010593:Pharmaceutical Services / Q000706:statistics & numerical data*; D010595:Pharmacists / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000458:organization & administration*; D024382:Professional Role; D016896:Treatment Outcome
D000959:Antihypertensive Agents