Assessing medication consultations, hypertension control, awareness, and treatment among elderly Asian community dwellers.

OBJECTIVE

To describe blood pressure (BP) and medication-related findings of a pharmacist-conducted hypertension (HTN) monitoring program.

STUDY DESIGN

Retrospective post hoc analysis.

SETTING

Community site.

PATIENTS

Multiethnic, community-dwelling, Asian older adults.

INTERVENTIONS

Medication consultation/BP records from 1998-2005 were reviewed. Participants' mean baseline BP readings were classified using guidelines from the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7) and stratified into three groups: < or =70, 71-79, and > or =80 years of age. Medication consultations were grouped into: lifestyle/general medication review, adherence assessment, non-HTN medication consults, and specific consults, which included pharmacist-provided, medication-related recommendations. Participants with specific consults and subsequent self-reported changes in HTN therapy were identified. Their mean BP readings at six months, before and after the self-reported changes, were assessed for differences, using paired t-test, P < or =0.05 was significant.

MAIN OUTCOME MEASURES

Baseline HTN treatment/awareness rates, age-stratified HTN control, number/types of HTN medications used, adherence problems, consultations provided, BP changes in participants who self-reported changes in medication therapy.

RESULTS

Among 414 participants (averaged 74.2 +/- 8.5 years of age, 34.1% male), baseline HTN rate, awareness rate, and treatment rates were 51.9%, 37.9%, and 24.9%, respectively. Baseline BP worsened with increasing age. Overall, 258 participants received 651 consultations. The most prevalent non-adherent behavior reported was self-adjustment of medication dosing. Among 65 participants who received HTN medication-related advice, 52/65 (80%) reported changes in medication therapy and showed significant improvement in BP at six months before and after the self-report.

CONCLUSION

HTN awareness/treatment rates were low in the entire population. HTN control was worst among the oldest individuals. Implementing initiation or adjustments in medication therapy can potentially improve BP control.