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Pharmacist intervention program for control of hypertension.

Isabelle Chabot1, Jocelyne Moisan, Jean-Pierre Grégoire

  • 1Department of Health Economics & Outcomes Research, Merck Frosst Canada Ltd., Kirkland, Québec, Canada. isabelle_chabot@merck.com

The Annals of Pharmacotherapy
|August 19, 2003
PubMed
Summary

Community pharmacy interventions improved blood pressure (BP) for high-income patients by enhancing adherence and lifestyle factors. Low-income patients did not benefit, indicating income disparities in hypertension management outcomes.

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Area of Science:

  • Pharmacoeconomics and Health Services Research
  • Cardiovascular Disease Management
  • Community Pharmacy Practice

Background:

  • Pharmaceutical care programs effectively improve hypertension outcomes.
  • Existing programs often require direct chart access and scheduled appointments, limiting accessibility.
  • Community pharmacy settings present an opportunity for accessible hypertension management.

Purpose of the Study:

  • To evaluate a community pharmacy-based intervention program on blood pressure (BP) control.
  • To identify factors influencing BP within a community pharmacy setting.
  • To assess the impact of pharmaceutical care on adherence and lifestyle in hypertensive patients.

Main Methods:

  • A 9-month controlled study in 9 community pharmacies involving 100 treated hypertensive patients.

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  • Utilized the PRECEDE-PROCEED model for intervention design and evaluation.
  • Pharmacists used a computerized decision-aid tool for pharmaceutical care in 4 pharmacies; 5 pharmacies provided usual care. Stratified analysis by family income.

    • Main Results:

    • Significant systolic BP reduction (-7.8 mm Hg) observed in the intervention group compared to control (0.5 mm Hg, p=0.01).
    • Benefits, including improved adherence and physical activity, were significant only in the high-income subgroup.
    • Low-income patients did not demonstrate significant improvement in BP or related factors.

    Conclusions:

    • Pharmacist-led interventions can positively influence adherence and reduce BP in hypertensive patients.
    • The effectiveness of pharmacist interventions on BP is significantly moderated by patient income status.
    • Targeted strategies may be needed to ensure equitable benefits of pharmaceutical care across different socioeconomic groups.