J Am Pharm Assoc (2003). 2022 Jul-Aug;62(4S):S41-S46.e1. doi: 10.1016/j.japh.2021.10.032. Epub 2021 Nov 3.
Hypertension is a leading cause of cardiovascular disease in the United States and is costing the health care system billions of dollars annually. A health program that combines education, empowerment, and monitoring has shown to improve clinical outcomes and decrease overall health care costs.
To describe the implementation and effectiveness of a self-measured blood pressure (SMBP) program in a community pharmacy.
An independent community pharmacy located within rural Southeast Missouri. On-site community pharmacists provide medication therapy management, adherence monitoring, immunizations, and reimbursed clinical services.
Patients were eligible if they were older than 18 years of age and fell into one of the following categories: self-reported a new hypertension diagnosis, self-reported a desire to SMBP, were referred by a provider, or had a medication change within the 3 months before enrollment. The program consisted of 4 patient sessions. The first session obtained an initial blood pressure and provided patient education and behavior counseling. Follow-up sessions obtained average SMBP readings and reinforced previously learned concepts.
Implementation was evaluated using time and patient satisfaction. Effectiveness was evaluated using number and type of clinical problems identified, BP measurements, and test scores.
A total of 20 patients enrolled and completed the study. The program took 63 minutes (SD ± 18) of staff time per patient for recruitment, sessions, reminder calls, and documentation. All patients received education and monitoring and 11 additional clinical problems were documented. Systolic BP decreased an average of 17 mm Hg (P = 0.002), and diastolic BP decreased an average of 12 mm Hg (P < 0.001). Patient confidence scores increased by 14%, and 7 more patients correctly answered the post-test knowledge question. All patients reported overall satisfaction with the program as "satisfied" or "very satisfied."
This standardized SMBP program effectively improved hypertension control and patient confidence in managing BP.
高血压是美国心血管疾病的主要病因，每年给医疗保健系统造成数十亿美元的损失。一项结合教育、赋权和监测的健康计划已被证明可以改善临床结果并降低整体医疗保健成本。
描述在社区药房中实施自我测量血压（SMBP）计划的情况和效果。
位于密苏里州东南部农村地区的独立社区药房。现场社区药剂师提供药物治疗管理、用药依从性监测、免疫接种和报销的临床服务。
如果患者年龄大于 18 岁，且符合以下类别之一，则有资格参加该计划：自我报告新的高血压诊断、自我报告希望进行 SMBP、由提供者推荐或在入组前 3 个月内药物发生变化。该计划包括 4 次患者就诊。第一次就诊时测量初始血压，并提供患者教育和行为咨询。随后的就诊测量平均 SMBP 读数并强化以前学到的概念。
使用时间和患者满意度评估实施情况。使用识别的临床问题数量和类型、血压测量值和测试分数评估效果。
共有 20 名患者入组并完成了研究。招募、就诊、提醒电话和记录每位患者的信息共需花费工作人员 63 分钟（标准差 ± 18）。所有患者均接受了教育和监测，另外还记录了 11 个临床问题。收缩压平均降低 17mmHg（P=0.002），舒张压平均降低 12mmHg（P<0.001）。患者信心评分提高了 14%，7 名患者正确回答了测试后的知识问题。所有患者均对该计划表示总体满意，满意度为“满意”或“非常满意”。
这项标准化的 SMBP 计划可有效改善高血压控制和患者管理血压的信心。
