Effect of pharmaceutical care on blood pressure control and health-related quality of life in patients with resistant hypertension.
OBJECTIVE
Verification of whether pharmacotherapeutic follow-up improves arterial blood pressure (BP) was conducted, and whether this improvement alters the quality of life of patients with resistant hypertension in a university teaching hospital in Brazil was determined.


METHODS
A prospective survey of 44 patients was carried out over a period of 20 months. Each patient was followed up for 12 months. Pharmaceutical care was assessed using the following methods: measurement of the office BP and ambulatory BP monitoring, adherence to therapy, drug-related problems, and the use of health care facilities (urgent care visits and hospital admissions). The health-related quality of life (HRQOL) of patients was also assessed using the 36-Item Short Form Health Survey (SF-36) questionnaire and a physical symptoms profile.


RESULTS
The majority (95.5%) of patients adhered to the treatment throughout the study, and there was a significant reduction in BP (p < 0.05). Nearly all of the domains of HRQOL assessed by SF-36 remained unchanged during the follow-up except for a significant improvement in social functioning (p = 0.041). There was a significant reduction in moderate and severe physical symptoms (p = 0.005). There were also significant reductions in the number of urgent care visits (p = 0.0001) and hospital admissions (p = 0.006).


CONCLUSIONS
The pharmaceutical care provided by a pharmacist in an ambulatory care clinic in Brazil improved BP, adherence to antihypertensive medications, and the social functioning of patients with resistant hypertension.
de Souza
Walnéia Aparecida
WA
Department of Pharmacy, Federal University of Alfenas, Alfenas, MG, Brazil. walne23@yahoo.com.br
Yugar-Toledo
Juan Carlos
JC
Bergsten-Mendes
Gun
G
Sabha
Maricene
M
Moreno
Heitor
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010593:Pharmaceutical Services; D011446:Prospective Studies; D011788:Quality of Life