title: Blood pressure evaluation and review of antihypertensive medication in patients with life limiting illness.
abstract: Background Patients with life limiting illness commonly have multiple co-morbidities that require the use of complex, costly pharmacotherapy. One such example is using medications to treat hypertension in life limiting illness. Objective To: (1) assess the prevalence of previously documented hypertension and associated blood pressure in a cohort of patients with life limiting illness; and, (2) assess the appropriateness of antihypertensive medication in this patient group. Method This was a single centre study at a tertiary, specialist palliative care centre in Northern England. Electronic medical notes were reviewed and data were extracted. Antihypertensive medication was assessed for appropriateness using a conceptual framework. Results A total number of 54 patients were included in the study. Twenty six (48.1 %) had previously documented hypertension: the mean blood pressure of which was 122/65 mmHg (SD 17.0/10.5), while for the normotensive patients it was 122/73 mmHg (SD 21.0/11.6). Of the 26 patients using antihypertensive medication, 25 were assessed as using the medication inappropriately. Conclusions The blood pressure for patients with previously documented hypertension who access specialist palliative care day services is commonly below the NICE target threshold. The majority of these patients are prescribed antihypertensive medications inappropriately.
authors.affiliation: Centre for Specialist Palliative Care, St Benedict's Hospice, Sunderland, UK.
authors.forename: Felicity
authors.initials: F
authors.lastname: Dewhurst
authors.affiliation: Centre for Specialist Palliative Care, St Benedict's Hospice, Sunderland, UK.
authors.forename: Lisa
authors.initials: L
authors.lastname: Baker
authors.affiliation: Centre for Specialist Palliative Care, St Benedict's Hospice, Sunderland, UK.
authors.forename: Inga
authors.initials: I
authors.lastname: Andrew
authors.affiliation: Division of Pharmacy, School of Medicine, Pharmacy and Health, Durham University, Stockton-on-Tees, UK. adam.todd@durham.ac.uk.
authors.forename: Adam
authors.initials: A
authors.lastname: Todd
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology; D001795:Blood Pressure Determination / Q000379:methods*; D015331:Cohort Studies; D016638:Critical Illness / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged
chemical_list: D000959:Antihypertensive Agents
keywords: Deprescribing; Hypertension; Inappropriate medication; Palliative care; United Kingdom