Lam Annie Y
Department of Pharmacy, University of Washington, Health Sciences Center, Seattle, Washington 98195, USA.
Consult Pharm. 2008 Oct;23(10):795-803. doi: 10.4140/tcp.n.2008.795.
To describe blood pressure (BP) and medication-related findings of a pharmacist-conducted hypertension (HTN) monitoring program.
Retrospective post hoc analysis.
Community site.
Multiethnic, community-dwelling, Asian older adults.
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.
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.
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.
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.
描述药剂师开展的高血压（HTN）监测项目中与血压（BP）及药物相关的结果。
回顾性事后分析。
社区场所。
多种族、居住在社区的亚洲老年人。
回顾1998 - 2005年的药物咨询/BP记录。根据美国国家联合委员会关于预防、检测、评估和治疗高血压的第七次报告（JNC - 7）的指南对参与者的平均基线BP读数进行分类，并分为三组：≤70岁、71 - 79岁和≥80岁。药物咨询分为：生活方式/一般药物审查、依从性评估、非HTN药物咨询以及特定咨询，其中特定咨询包括药剂师提供的与药物相关的建议。确定接受特定咨询以及随后自我报告HTN治疗有变化的参与者。使用配对t检验评估他们在自我报告变化前后六个月的平均BP读数差异，P≤0.05具有显著性。
基线HTN治疗/知晓率、按年龄分层的HTN控制情况、使用的HTN药物数量/类型、依从性问题、提供的咨询、自我报告药物治疗有变化的参与者的BP变化。
在414名参与者中（平均年龄74.2±8.5岁，男性占34.1%），基线HTN发病率、知晓率和治疗率分别为51.9%、37.9%和24.9%。基线BP随年龄增长而恶化。总体而言，258名参与者接受了651次咨询。报告的最普遍的不依从行为是自行调整药物剂量。在65名接受HTN药物相关建议的参与者中，52/65（80%）报告了药物治疗的变化，并且在自我报告前后六个月的BP显示出显著改善。
整个人群的HTN知晓率/治疗率较低。年龄最大的个体中HTN控制最差。实施药物治疗的起始或调整可能会改善BP控制。
