Evaluation of a pharmaceutical care program for hypertensive patients in rural Portugal.

OBJECTIVES

To evaluate the community pharmacist's capacity to positively influence the results of antihypertensive drug therapy through a pharmaceutical care program and to determine what factors limit the program.

DESIGN

Randomized, controlled study.

SETTING

Private pharmacy caring for a semiliterate, rural Portuguese population.

PATIENTS

Random sample of 100 patients with a diagnosis of essential hypertension who had been on drug treatment for less than 6 months. Patients were randomly assigned to an intervention (n = 50) or a control (n = 50) group.

INTERVENTION

Individualized health promotion by a research pharmacist involving monthly appointments for 6 months to monitor blood pressure; assess adherence to treatment; prevent, detect, and resolve drug-related problems (DRPs); and encourage nonpharmacologic measures for blood pressure control. Control patients received traditional care.

MAIN OUTCOME MEASURES

Control of blood pressure; decreases in systolic/diastolic blood pressure; number of detected, resolved, and prevented DRPs.

RESULTS

From the initial sample of 100 patients, 41 patients in the intervention group and 41 patients in the control group completed the longitudinal study. After 6 months, prevalence of uncontrolled blood pressure decreased by 77.4% in the intervention group (P < .0001) and by 10.3% in the control group (P = .48). Systolic blood pressure fell from a mean +/- standard deviation of 152 mm Hg +/- 23 mm Hg to 129 +/- 15 mm Hg in intervention patients and 148 +/- 16 mm Hg to 143 +/- 20 mm Hg in control patients (P < .001). Twenty-four of 29 (83%) detected actual DRPs were resolved. About 40% of potential DRPs were prevented.

CONCLUSION

In this rural community, a pharmaceutical care program was associated with significant improvements in blood pressure control in hypertensive patients.