Hypertensive Patient Compliance with Pharmacist Intervention: A Systematic Review

Background: Pharmacists and physicians can work together to improve patient compliance especially for the management of hypertension. Medication adherence leads to advance health and reduces hospitalizations (morbidity), death (mortality) and healthcare costs. Objectives: Involvement of pharmacist in treatment intervention can result in improved understanding about hypertension and it can increase medication adherence to antihypertensive therapy which ultimately advance overall quality of life. Study design and methods: A comprehensive research study was conducted using two eminent databases i.e. PUBMED and EMBASE. The research articles from 1996 to 2015 were analyzed. All the selected articles were about pharmacist intervention, hypertensive patient compliance and hypertension medication adherence. Results: Some studies show no control in BP; however, there was significant difference in the systolic and diastolic BP pre and post pharmacist intervention (Systolic from 158.1±14.4 to 143.8 ± 10.7, Diastolic from 100.6 ±11.5 to 89.8 ± 9.7). Conversely, in some studies BP was controlled in about 29.9% of control group and in 63% of the intervention group. Conclusion: Results showed many methods can improve medication adherence and blood pressure including counseling patients in person, collaboration between pharmacists and physicians, and using technology like telecommunication to intensify patients counseling. Pharmacist intervention can significantly increase disease-related knowledge, blood pressure control and medication adherence in patients with hypertension.

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Abstract P112: Changes in Lifestyle Behavior to Reduce Uncontrolled Blood Pressure in the Faith Trial

Circulation ◽

10.1161/circ.131.suppl_1.p112 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Kristie J Lancaster ◽

Antoinette M Schoenthaler ◽

William Chaplin ◽

Gbenga Ogedegbe

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Medication Adherence ◽

Lifestyle Modification ◽

Intervention Group ◽

Black Americans ◽

Control Group ◽

Lifestyle Behaviors ◽

Uncontrolled Blood Pressure ◽

Faith Based

Introduction: Modifying lifestyle behaviors is a key method for controlling hypertension. This strategy is extremely important for hypertensive Black Americans, as they are more likely to have uncontrolled blood pressure (BP), have a higher risk of complications, and poorer outcomes. To address this need, we conducted a cluster-randomized controlled trial to reduce BP through lifestyle modification that was delivered by lay health advisors in Black churches. The Faith-based Approaches in the Treatment of Hypertension (FAITH) trial was designed to evaluate the effectiveness of a 12-week faith-based lifestyle intervention and subsequent 3-month motivational interviewing vs. health education control on BP reduction among hypertensive Black adults. This study examines the change in lifestyle behaviors during the trial from baseline to 6 months. Methods: We recruited 373 Black Americans with uncontrolled hypertension from 32 urban churches. BP was considered to be uncontrolled if systolic BP (SBP)≥140 mmHg or diastolic BP (DBP)≥90 mmHg, or DBP≥130 mmHg or DBP≥80 mmHg for participants with self-reported diabetes or kidney disease The primary outcome was within-participant change in BP from baseline to 6 months. Lifestyle data collected included the NCI fruit/vegetable intake screener and % calories from fat screener, the International Physical Activity Questionnaire (IPAQ), medication adherence, and measured height and weight. Results: Participants’ mean age was 63.4 y, 76.4% were female, and 96.1% reported being of African descent. The mean BMI was 32.1 kg/m2. At 6 months, the intervention was associated with significant reduction in SBP but not DBP compared with the control group (-16.0 mmHg vs -10.3 mmHg, p=0.017). There was no significant change in number of servings of fruits and vegetables consumed, minutes walked per day, or weight for either group. However, the intervention group had a slight but significantly greater decrease of 1.08 % calories from fat over time compared with the control (p=0.018), but that change was not related to change in SBP. Most notably, there was a significant months x treatment interaction on medication adherence the intervention group had a greater decrease in non-adherence score than the control (-0.84 vs -0.30, p=0.28). This improvement in adherence was related to decrease in SBP (p=0.019). Conclusion: Community-based lifestyle modification program led to significantly reduced systolic BP; and this intervention effect was mediated by improved medication adherence. However, the 12-week intervention resulted in little change in key diet and physical activity behaviors found in other trials to positively affect BP.

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Effects of Confounding Factors on Blood Pressure in Hypertensive Patients: A Cross Sectional Study

10.21203/rs.3.rs-283642/v1 ◽

2021 ◽

Author(s):

Emrah Ersoy ◽

Cuneyt Ardic

Keyword(s):

Blood Pressure ◽

Blood Pressure Control ◽

Pressure Control ◽

Control Group ◽

Poor Sleep ◽

Study Group ◽

Confounding Factors ◽

Cross Sectional ◽

Hypertensive Patients ◽

Significant Difference

Abstract Background Blood pressure is influenced by biopsychosocial factors such as physical, environmental, emotional, cognitive and behavioral in hypertensive patients. ObjectiveThe aim of this study is to investigate confounding factors in hypertensive patients who have poor blood pressure control.DesignThis study was designed as a cross-sectional study.ParticipantsOur sample was 407 patients with hypertension in Rize, a Northern city in the Black Sea Region of Turkey. In study group, there were 207 hypertensive patients who had admission to emergency department due to high blood pressure. In control group, there were 200 hypertensive patients visiting family physician,who defined themselves as having regulated blood pressure over the past six months.Main MeasuresPatients completed the questionnaire including sociodemographic data, lifestyle behaviors, health risks and confounding factors via the face-to-face interview method. Key ResultsOf the hypertensive patients, 81.2% (n=168) of the study group and 34.0% (n=68) of the control group had confounding factors. There was a significant difference between the hypertensive patients of study and control group in terms of their confounding factors (p<0.001). When we asked the patients of study group questions to reveal their confounding factors, 21.3% (n=44) stated ‘anger’, 12.6% (n=26) ‘sadness’, 11.1% (n=23) ‘anxiety’, 10.6% (n=22) ‘depressed’, 9.2% (n=19) ‘unhealthy diet’, 7.2% (n=15) ‘fatigue and poor sleep quality’, and 3.9% (n=8) ‘irregular medication’. Mean systolic and diastolic blood pressure were significantly higher in hypertensive patients having confounding factors than those without confounding factors (p=0.001, p=0.001, respectively). Mean systolic blood pressure of hypertensives who stated their confounding factor as ‘anger’ was significantly higher than those the remaining groups (p<0.001).ConclusionsThis study has shown that confounding factors impair blood pressure control in patients with hypertension. Confounding factors should be kept in mind and revealed in case of poor blood pressure control in hypertensive patients.

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Effects of a Meal Replacement on Body Composition and Metabolic Parameters among Subjects with Overweight or Obesity

Journal of Obesity ◽

10.1155/2018/2837367 ◽

2018 ◽

Vol 2018 ◽

pp. 1-10 ◽

Cited By ~ 5

Author(s):

Xiaohui Guo ◽

Yifan Xu ◽

Hairong He ◽

Hao Cai ◽

Jianfen Zhang ◽

...

Keyword(s):

Blood Pressure ◽

Body Composition ◽

Total Energy ◽

Intervention Group ◽

Overweight And Obesity ◽

Metabolic Parameters ◽

Control Group ◽

Meal Replacement ◽

Significant Difference ◽

The Impact

Meal replacement plans are effective tools for weight loss and improvement of various clinical characteristics but not sustainable due to the severe energy restriction. The aim of the study was to evaluate the impact of meal replacement, specifically 388 kcal in total energy, on body composition and metabolic parameters in individuals with overweight and obesity from a Chinese population. A parallel, randomized controlled trial was performed with 174 participants (ChiCTR-OOC-17012000). The intervention group (N=86) was provided with a dinner meal replacement, and the control group (N=88) continued their routine diet as before. Body composition and blood parameters were assessed at 0, 4, 8, and 12 weeks. A post hoc analysis (least significant difference (LSD) test), repeated measurements, and pairedT-test were used to compare each variable within and between groups. Significant (p<0.001) improvements in body composition components were observed among the intervention group, including body weight (−4.3 ± 3.3%), body mass index (−4.3 ± 3.3%), waist circumference (−4.3 ± 4.4%), fat-free mass (−1.8 ± 2.9%), and body fat mass (−5.3 ± 8.8%). Body composition improvements corresponded with significant metabolic improvements of blood glucose (−4.7 ± 9.8%). Further improvements in visceral fat area (−7.7 ± 10.1%), accompanying with improvements in systolic (−3.7 ± 6.9%) and diastolic (−5.3 ± 7.7%) blood pressure, were only found in male subjects. To conclude, meal replacement intake with 388 kcal in total energy at dinner time for 12 weeks contributed to improvement in body composition and clinically significant metabolic parameters in both male and female participants with overweight/obesity. Additionally, glucose and blood pressure reduction were gender-specific highlighting the importance of gender stratification for design of nutritional intervention studies for improvement of health.

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The Effect of Pharmaceutical Care Programs on Blood Pressure Control in Individuals with Hypertension: A Meta-Analysis

Journal of Pharmacy Technology ◽

10.1177/875512250902500503 ◽

2009 ◽

Vol 25 (5) ◽

pp. 292-296 ◽

Cited By ~ 2

Author(s):

Yongbing Ni ◽

Yongfa Chen ◽

Wenlong Huang

Keyword(s):

Blood Pressure ◽

Pharmaceutical Care ◽

Blood Pressure Control ◽

Meta Analysis ◽

Intervention Group ◽

Pressure Control ◽

Control Group ◽

Randomized Controlled ◽

Program Intervention ◽

Review Manager

Objective: To evaluate the effect of pharmaceutical care (PC) programs on blood pressure control in individuals with hypertension. Methods: Studies were retrieved by searching MEDLINE, EMBASE, Cochrane, CNKI, and CBM databases from 1999 to February 2008. Randomized controlled trials (RCTs) on the association of pharmaceutical care programs with blood pressure control in individuals with hypertension were included in this study. Moreover, the studies were selected independently by 2 authors. The analysis was conducted by using Review Manager version 4.2 software. Results: Five RCTs with a total of 585 patients with hypertension were included in this meta-analysis. Compared with the control group, the PC program intervention group had significantly lower endpoint systolic blood pressure (SBP) and diastolic blood pressure (DBP). Moreover, SBP and DBP were significantly improved in the intervention group relative to the control group. Conclusions: PC programs appear to be an effective tool in helping to control blood pressure in hypertensive patients.

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The Effect of Wet Cupping on Baroreceptor Sensitivity in Hypertensive Patients in Sidenreng Rappang Regency, South Sulawesi

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.6891 ◽

2021 ◽

Vol 9 (G) ◽

pp. 217-222

Author(s):

Fadli Fadli ◽

Sumbara Sumbara ◽

Arabta M. Peraten Pelawi ◽

Suratun Suratun ◽

Rohandi Baharuddin

Keyword(s):

Blood Pressure ◽

Intervention Group ◽

Pulse Frequency ◽

Cupping Therapy ◽

Control Group ◽

Autonomic Nerves ◽

Baroreceptor Sensitivity ◽

Hypertensive Patients ◽

South Sulawesi ◽

Significant Difference

Wet cupping therapy removes toxins thereby increasing blood flow and stimulating baroreceptors sensitivity which provides a stimulus to the autonomic nerves. This stimulus reduces the sympathetic nerves’ work and inhibits the vasomotor center, leading to vasodilation, therefore decreasing blood pressure and pulse frequency. This research aims to determine the effect of wet cupping therapy on baroreceptors sensitivity with blood pressure and pulse frequency indicators. It was conducted in Sidenreng Rappang Regency, South Sulawesi, eastern Indonesia from February to May 2021. Randomized Controlled Trial (RCT) method was used including two groups of 31 respondents each. The intervention group used wet cupping therapy to regulate anti-hypertensive drugs and the control group used anti-hypertensive drugs with blood pressure and pulse frequency measurements until 6 weeks after the therapy. Wet cupping affects baroreceptor sensitivity by reducing the indicators. The result showed a significant difference in blood pressure measurement (systolic; diastolic) before and after the 2-week follow-up period (P = 0.000; P = 0.001), and between 2 and 4 weeks (P = 0.000; P = 0.000), but between 4 and 6 weeks there was no significant difference in the intervention group (P = 0.248; P = 0.583). There was a significant difference in pulse frequency at 2 and 4 weeks after the intervention (P = 0.016). In conclusion, wet cupping therapy effectively increases baroreceptor sensitivity by reducing blood pressure and pulse frequency indicators in hypertensive patients up to 4 weeks limit after the therapy, without any serious side effects experienced by respondents.

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The impact of using BASNEF model on self-control behaviors among Patients with hypertension

Internal Medicine And Medical Investigation Journal ◽

10.24200/imminv.v3i3.127 ◽

2018 ◽

Vol 3 (3) ◽

pp. 112

Author(s):

Moradali Zareipour ◽

Mousa Ghelichi Ghojogh ◽

Masoumeh Mahdi-akhgar ◽

Sarvin Abbasi ◽

Nooshin Yoshany ◽

...

Keyword(s):

Blood Pressure ◽

Intervention Group ◽

Public Health Problem ◽

Developed Countries ◽

Self Control ◽

Control Group ◽

Validity And Reliability ◽

Important Public Health Problem ◽

Significant Difference ◽

The Impact

Background: High blood pressure is the most important public health problem in developed countries. It is one reason for early mortality and risk factors for cardiovascular diseases like stroke and kidney failure. This study aimed to determine the effect of educational intervention based on BASNEF in blood pressure control in 1395.Methods and Materials: This study was a quasi-experimental study on 160 patients in two groups (each n = 80) suffering from hypertension in urban health centers of Urmia. Data collection questionnaire included: demographic questions, knowledge base questions, self-control behaviors questions and structures of BASNEF model. Validity and reliability were respectively 80% and 79%. Intervention group had taken three 45 minutes sessions using speeches, questions and answers, posters, booklets, pamphlets and whiteboard. Before training, information collected through questionnaires and after training questionnaires were completed again after 3 months. The data were analyzed in SPSS software with chi-square tests, Fisher, independent and paired sample t-test.Results: The average age of case and control group were 99.11 ± 01.56 and 75.12 ± 66.53 years. That there was no statistically significant difference (p=0.1). After intervention average systolic blood pressure significantly decreased in the intervention group from 43.157 to 24.147 mm Hg and diastolic blood pressure significantly decreased from 21.93 to 52.87 mm Hg (P <0.05)Conclusion: The training program using BASNEF model has provided better results in controlling blood pressure than conventional trainings.

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THE EFFECT OF THE POP-UP BOOK AKU DAN GIGIKU ON BLOOD PRESSURE IN CHILDREN AGED 4–6 YEARS

International Journal of Applied Pharmaceutics ◽

10.22159/ijap.2017.v9s2.45 ◽

2018 ◽

Vol 9 ◽

pp. 165

Author(s):

Kusuma P Adriani ◽

Margaretha Suharsini ◽

Eva Fauziah2 ◽

Meutia D Citrawuni

Keyword(s):

Blood Pressure ◽

Dental Treatment ◽

Dental Anxiety ◽

Intervention Strategy ◽

Intervention Group ◽

Control Group ◽

Physiological Changes ◽

Waiting Room ◽

Significant Difference ◽

And Control

Objective: This study aimed to evaluate the effectiveness of the pop-up book Aku dan gigiku as an intervention strategy in reducing anxiety in young children before dentaltreatment.Methods: 78 children aged 4–6 years were randomly divided into two groups: An intervention group with the pop-up book intervention and a control group without the pop-up book intervention. They were placed in a waiting room, and their blood pressure was measured. The experimental design of this clinical research was statistically analyzed using independent t-tests to compare decreased blood pressure between the intervention and control groups.Results: The result of the study revealed that there was a statistically significant difference in decreased blood pressure with the intervention of the pop-up book Aku dan gigiku. As dental anxiety leads to undesirable distresses, it generates physiological changes such as blood pressure. Interventions should thus be undertaken to reduce dentalanxiety, and the pop-up book is an example of an intervention medium as it educates children and presents interesting illustrations.Conclusion: The pop-up book Aku dan gigiku thus appears to be an effective method in reducing anxiety in children aged 4–6 years when used as an intervention strategy before dental treatment.

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Evaluating the Impact of Outpatient Multi-Dose Medication Packaging Service (MDMPS) on Medication Adherence and Clinical Outcomes

Journal of Primary Care & Community Health ◽

10.1177/2150132720965085 ◽

2020 ◽

Vol 11 ◽

pp. 215013272096508

Author(s):

Pratibha Nair ◽

Kok Wai Kee ◽

Choon Siong Mah ◽

Eng Sing Lee

Keyword(s):

Blood Pressure ◽

Medication Adherence ◽

Clinical Outcomes ◽

Low Density Lipoprotein ◽

Medication Possession Ratio ◽

Density Lipoprotein ◽

Control Group ◽

Improve Medication Adherence ◽

Standard Medication ◽

The Impact

Background: There is limited understanding on the impact of the multidose medication packaging service (MDMPS). Objectives: The main objective of this study was to evaluate changes in medication adherence in patients using MDMPS compared to patients receiving standard medication packaging (control group). The other objectives were to determine the association between medication adherence and clinical outcomes, and to assess patients’/caregivers’ perceptions toward MDMPS. Methods: A retrospective cohort study was conducted among primary care patients in Singapore enrolled into MDMPS between 2012 and 2017. Eligible patients were taking at least five chronic medications, diagnosed with Hypertension, Hyperlipidemia and/or Type 2 Diabetes, with prescription records for at least six months before and after the index period. They were matched to control patients based on the type of comorbidities and medication adherence status. Medication Possession Ratio (MPR), glycated hemoglobin (HbA1c), blood pressure and low-density lipoprotein-cholesterol (LDL-C) of both groups were compared between baseline and at least six months post-index period. Interviewer-administered questionnaires were also conducted for MDMPS patients. Results: The MPR of MDMPS patients (n = 100) increased by 0.37% ( P < .001) compared to the control group (n = 100). MDMPS patients with diabetes had reduced HbA1c by 0.1% after six months ( P = .022) but was not significant after 12 months. No significant changes were seen in blood pressure and LDL-C between both groups. At least 50% of patients were highly satisfied with MDMPS. Conclusion: MDMPS can improve medication adherence. Further studies are needed to understand its clinical impact.

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The Effect of 5A Self-management Program on Medication Adherence of Epileptic Patients in During the COVID – 19 Pandemic

10.21203/rs.3.rs-1131999/v1 ◽

2021 ◽

Author(s):

Seyede Fateme Moosavimoghadam ◽

Ali Dehghani ◽

Rasool Eslami Akbar

Keyword(s):

Medication Adherence ◽

Intervention Group ◽

Management Training ◽

Wilcoxon Test ◽

Self Management ◽

Control Group ◽

Control Groups ◽

Significant Difference ◽

Epileptic Patients ◽

And Control

Abstract Background: Adherence to medication adherence plays a vital role in controlling the problems and complications of epilepsy. During the COVID – 19 pandemic and limitations of face-to-face education, the use of distance education can play an important role in providing education to patients. Therefore, the aim of this study is the effect of model 5A self-management training on medication adherence in epileptic patients.Methods: In this single-blind randomized controlled trial, 56 epilepsy patients referred to Shiraz Namazi Hospital were divided into intervention and control groups using random allocation. Thereafter, 5A self - management training sessions were virtually held in 5 sessions in WhatsApp application for intervention group. The data collection tool was Morisky medication adherence scale at two stages of before and two months after intervention. Data analysis was performed using SPSS 21 software.Results: The results of Wilcoxon test showed that in intervention group, the mean drug adherence in patients after intervention significantly increased compared to before intervention (p = 0.005). But in control group, this was not significant (p = 0.909). According to results of Mann-Whitney test, there was no significant difference between intervention and control groups before intervention (p = 0.632). However, by passing two months from intervention, a significant difference was found between intervention and control groups (p = 0.041).Conclusion: Based on results, the implementation of Model 5A can be effective on medication adherence in epilepsy patients. This program can be considered as a suitable method in epileptic patients in during COVID – 19 pandemic.

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Pharmacist-Led Discharge Medication Counseling and its Corresponding Impact on Medication Adherence and Hospital Readmission Rates

INNOVATIONS in pharmacy ◽

10.24926/iip.v11i3.3352 ◽

2020 ◽

Vol 11 (3) ◽

pp. 6

Author(s):

Savannah Cunningham ◽

Joshua D. Kinsey

Keyword(s):

Medication Adherence ◽

Hospital Readmission ◽

Intervention Group ◽

Control Group ◽

Readmission Rates ◽

Discharge Medication ◽

Hospital Readmission Rates ◽

Medication Counseling ◽

Significant Difference

Objectives: Pharmacists have been shown to reduce hospital readmission rates and improve adherence rates by providing discharge medication counseling and offering services such as a bedside delivery program.1 Hospitals are now penalized by Medicare if patients are readmitted within 30 days of discharge, so implementation of these programs have the potential to be financially significant as well.2 The primary endpoint of this study is to evaluate the impact of a pharmacist discharge medication counseling bedside delivery program on medication adherence rates within a six-week period following discharge. The secondary endpoint focuses on hospital readmission rates. The objective of this study is to increase collaboration between community pharmacies and hospitals in order to improve the quality of patient care. Methods: This study was designed as intervention versus control, whereas the intervention patients were those who received counseling from a pharmacist or pharmacist intern and control patients were those who did not within the same time period. Collected patient data (n=81) included patients’ demographic data and all disease states, genders, and insurance coverage were encompassed by the included patients. Medication adherence was measured at follow-up intervals utilizing the proportion of days covered (PDC) equation, where a score of at least 80% is required for optimal therapeutic efficacy. Informed consent was obtained from all participants regarding a follow-up telephone call or retrieval of medication records through the pharmacy electronic medication records system and hospital electronic medical records system. Approximately 10-15-minute counseling sessions were performed at the time of discharge. Follow-up phone calls were conducted for the intervention group at four-weeks and six-weeks post-discharge using an eight-item Morisky medication adherence survey to discuss medication adherence and side effects experienced. Results: There was a total of 81 patients enrolled in this study. There were 27 patients in the intervention group and 54 patients in the control group. These pharmacist-led discharge counseling sessions made a statistically significant difference in medication adherence rates (P=<0.001) as calculated using PDC, showing adherence rates of 84.4% in the intervention group and 62.8% in the control group. The pharmacist-led discharge counseling sessions did not make a statistically significant difference in hospital readmission rates, though investigators do expect to see an impact on clinical and financial endpoints. Conclusion: Pharmacist involvement in a bedside delivery program helps to improve medication adherence in patients being discharged from a hospital. A PDC of at least 80% is required for optimal therapeutic efficacy in most classes of chronic medications, and only the intervention arm reached this threshold.13 Although this study’s sample size was not sufficient to show a statistically significant difference in reduced hospital readmission rates for patients receiving a pharmacist-led discharge counseling session, the findings show the potential for a clinical impact and improved patient outcomes due to increased adherence rates. Original Research

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