Clinical value of blood pressure measurement in the community pharmacy.
OBJECTIVE
To investigate whether the measurement of blood pressure in the community pharmacy is a valuable method to diagnose hypertension, to assess the need and the effectiveness of anti-hypertensive treatments, or, in general, to make clinical decisions.


METHODS
Information has been extracted from articles published in English and in Spanish, from January 1989 to December 2009, in indexed magazines in MEDLINE and EMBASE. To perform the search, multiple and specified terms related to the community pharmacy setting, to blood pressure measurement and to the comparison and agreement between blood pressure measurement methods were used. Selected articles were those that: (1) compared and/or measured the agreement (concordance) between community pharmacy blood pressure measurements obtained in repeated occasions, or (2) compared and/or measured the agreement between the community pharmacy blood pressure measurement method and other measurement methods used in clinical practice for decision-making purposes: blood pressure measurement by a physician, by a nurse and home or ambulatory blood pressure monitoring. Articles were included and analyzed by two investigators independently, who essentially extracted the main results of the manuscripts, emphasizing the assessment of the blood pressure measurement methods used and the completed statistical analysis.


RESULTS
Only three studies comparing the community pharmacy blood pressure measurement method with other methods and one comparing repeated measurements of community pharmacy blood pressure were found. Moreover, these works present significant biases and limitations, both in terms of method and statistical analysis, which make difficult to draw consistent conclusions.


CONCLUSIONS
Further research of high quality is needed, which results can guide the clinical decision-making based on the community pharmacy blood pressure measurement method.
Sabater-Hernández
Daniel
D
Grupo de Investigación en Atención Farmacéutica, Universidad de Granada, Campus Universitario de Cartuja S/N, 18071, Granada, Spain. dsabater@gmail.com
Azpilicueta
Inés
I
Sánchez-Villegas
Pablo
P
Amariles
Pedro
P
Baena
María I
MI
Faus
María J
MJ
D000959:Antihypertensive Agents / Q000627:therapeutic use; D001795:Blood Pressure Determination / Q000379:methods*; D003157:Community Pharmacy Services; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D015588:Observer Variation
D000959:Antihypertensive Agents