Implementation and evaluation of a pharmacist-led hypertension management service in primary care: Outcomes and methodological challenges

Bajorek, B; Lemay, KS; Magin, P; Roberts, C; Krass, I

Implementation and evaluation of a pharmacist-led hypertension management service in primary care: Outcomes and methodological challenges

Bajorek, B

Lemay, KS Magin, P Roberts, C Krass, I

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Publication Type:: Journal Article
Citation:: Pharmacy Practice, 2016, 14 (2)
Issue Date:: 2016-04-01

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Field	Value	Language
dc.contributor.author	Bajorek, B https://orcid.org/0000-0002-2532-7187	en_US
dc.contributor.author	Lemay, KS	en_US
dc.contributor.author	Magin, P	en_US
dc.contributor.author	Roberts, C	en_US
dc.contributor.author	Krass, I	en_US
dc.date.available	2016-05-01	en_US
dc.date.issued	2016-04-01	en_US
dc.identifier.citation	Pharmacy Practice, 2016, 14 (2)	en_US
dc.identifier.uri	http://hdl.handle.net/10453/117182
dc.description.abstract	© 2016, Grupo de Investigacion en Atencion Farmaceutica. All rights reserved. Background: Suboptimal utilisation of pharmacotherapy, non-adherence to prescribed treatment, and a lack of monitoring all contribute to poor blood (BP) pressure control in patients with hypertension. Objective: The objective of this study was to evaluate the implementation of a pharmacist-led hypertension management service in terms of processes, outcomes, and methodological challenges. Method: A prospective, controlled study was undertaken within the Australian primary care setting. Community pharmacists were recruited to one of three study groups: Group A (Control – usual care), Group B (Intervention), or Group C (Short Intervention). Pharmacists in Groups B and C delivered a service comprising screening and monitoring of BP, as well as addressing poor BP control through therapeutic adjustment and adherence strategies. Pharmacists in Group C delivered the shortened version of the service. Results: Significant changes to key outcome measures were observed in Group C: reduction in systolic and diastolic BPs at the 3-month visit (P<0.01 and P<0.01, respectively), improvement in medication adherence scores (P=0.01), and a slight improvement in quality of life (EQ-5D-3L Index) scores (P=0.91). There were no significant changes in Group B (the full intervention), and no differences in comparison to Group A (usual care). Pharmacists fed-back that patient recruitment was a key barrier to service implementation, highlighting the methodological implications of screening. Conclusion: A collaborative, pharmacist-led hypertension management service can help monitor BP, improve medication adherence, and optimise therapy in a step-wise approach. However, blood pressure screening can effect behaviour change in patients, presenting methodological challenges in the evaluation of services in this context.	en_US
dc.relation.ispartof	Pharmacy Practice	en_US
dc.relation.isbasedon	10.18549/PharmPract.2016.02.723	en_US
dc.subject.classification	Pharmacology & Pharmacy	en_US
dc.title	Implementation and evaluation of a pharmacist-led hypertension management service in primary care: Outcomes and methodological challenges	en_US
dc.type	Journal Article
utslib.citation.volume	2	en_US
utslib.citation.volume	14	en_US
utslib.for	1115 Pharmacology and Pharmaceutical Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
utslib.copyright.status	open_access
pubs.issue	2	en_US
pubs.publication-status	Published	en_US
pubs.volume	14	en_US

Abstract:

© 2016, Grupo de Investigacion en Atencion Farmaceutica. All rights reserved. Background: Suboptimal utilisation of pharmacotherapy, non-adherence to prescribed treatment, and a lack of monitoring all contribute to poor blood (BP) pressure control in patients with hypertension. Objective: The objective of this study was to evaluate the implementation of a pharmacist-led hypertension management service in terms of processes, outcomes, and methodological challenges. Method: A prospective, controlled study was undertaken within the Australian primary care setting. Community pharmacists were recruited to one of three study groups: Group A (Control – usual care), Group B (Intervention), or Group C (Short Intervention). Pharmacists in Groups B and C delivered a service comprising screening and monitoring of BP, as well as addressing poor BP control through therapeutic adjustment and adherence strategies. Pharmacists in Group C delivered the shortened version of the service. Results: Significant changes to key outcome measures were observed in Group C: reduction in systolic and diastolic BPs at the 3-month visit (P<0.01 and P<0.01, respectively), improvement in medication adherence scores (P=0.01), and a slight improvement in quality of life (EQ-5D-3L Index) scores (P=0.91). There were no significant changes in Group B (the full intervention), and no differences in comparison to Group A (usual care). Pharmacists fed-back that patient recruitment was a key barrier to service implementation, highlighting the methodological implications of screening. Conclusion: A collaborative, pharmacist-led hypertension management service can help monitor BP, improve medication adherence, and optimise therapy in a step-wise approach. However, blood pressure screening can effect behaviour change in patients, presenting methodological challenges in the evaluation of services in this context.

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http://hdl.handle.net/10453/117182