Impact of pharmacy outreach services on blood pressure management in the elderly community of Hong Kong.
OBJECTIVE
To investigate the impact of the Pharmacy Outreach Service (POS) on blood pressure (BP) and disease knowledge among community-dwelling elderly patients with hypertension, and to evaluate the sustainability of such impact of POS.


METHODS
A prospective open-labeled study of elderly adults (aged ≥65 years) with hypertension (BP ≥140/90 mmHg for non-diabetics and ≥130/80 mmHg for diabetics) was carried out at seven elderly community centers from July 2008 to March 2010. Pharmacists provided BP monitoring, medication review and disease knowledge assessment. The target BP was <140/90 mmHg for non-diabetics and <130/80 mmHg for diabetics. The primary outcome was BP change, whereas the secondary outcome was the change of disease knowledge of hypertension. All outcomes were compared between baseline and the last visit. For POS 2008/09 participants, BP was compared between values obtained during POS 2008/09 and 2009/10.


RESULTS
A total of 97 participants were recruited. Systolic BP reduced significantly from 152.38±18.80 mmHg to 147.04±20.72 mmHg (P=0.021), and diastolic BP reduced from 73.84±11.36 mmHg to 71.03±10.97 mmHg (P=0.010). Cumulative reductions in mean systolic BP and diastolic BP throughout the 2-year study period were 21.39±24.72 mmHg and 9.88±13.48 mmHg, respectively (P<0.001). A 12% increase in the at-goal rate was observed in new participants recruited in 2009 (P=0.039). Disease knowledge of hypertension improved significantly (P<0.005), particularly in areas that included the definition of hypertension, diet and lifestyle modification.


CONCLUSIONS
The POS might improve blood pressure control, hypertension and diabetes knowledge in elderly adults with hypertension in Hong Kong. The effect on blood pressure improvement was sustainable.
School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong. vivianlee@cuhk.edu.hk
Vivian W Y
VW
Lee
Pang Tin
PT
Yi
Kathy W Y
KW
Kong
Peter K H
PK
Chan
Fanny L M
FL
Kwok
D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000458:organization & administration*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D018660:Blood Pressure Monitoring, Ambulatory; D003157:Community Pharmacy Services / Q000458:organization & administration*; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies; D011795:Surveys and Questionnaires
D000959:Antihypertensive Agents