School of Pharmacy, Kathmandu University, Dhulikhel, Nepal.
School of Pharmacy, The University of Queensland, Brisbane, Queensland, Australia
Eur J Hosp Pharm. 2023 Nov;30(6):316-321. doi: 10.1136/ejhpharm-2020-002512. Epub 2022 Jan 3.
Patients with hypertension in Nepal are often known to have poor medication adherence and quality of life. This randomised controlled trial aimed to evaluate the impact of a hospital pharmacist-delivered individualised pharmaceutical service (P-DIPS) intervention on blood pressure, medication adherence and health-related quality of life (HRQoL) among patients with hypertension in a hospital setting in Nepal.
In an open trial, 56 adult patients with hypertension who had been receiving antihypertensive medication for ≥6 months were randomly allocated to a control group (n=28) which received the usual care and an intervention group (n=28) which received a P-DIPS along with the usual care. The difference in blood pressure, medication adherence and HRQoL between the two groups at baseline, 2 and 4 months was compared using the Mann-Whitney U test, independent t-test or χ tests.
Participants were mostly ≥40 years (86%) and female (57%). There were no significant differences in the baseline characteristics between the control (C) and intervention (I) groups. At 2 months, the two groups had a significant improvement in the median (IQR) Morisky-Green-Levine (MGL) Medication Adherence Score (I=1 (2) vs C=2 (2); p<0.001) and the median (IQR) mental component of HRQoL (I=43.6 (9.5) vs C=37.5 (8.6); p=0.013). At 4 months, there were significant differences in the median (IQR) values of all the outcome measures between the groups (systolic blood pressure: I=125 (10) mmHg vs C=130 (15) mmHg, p=0.008; diastolic blood pressure: 80 (14) mmHg vs 90 (10) mmHg, p=0.012; MGL score: I=1 (1) vs C=2 (1), p<0.001; physical component of HRQoL: 45.0 (9.0) vs 40.3 (8.2), p=0.046; and mental component of HRQoL: 47.1 (11.1) vs 38.8 (8.5), p=0.003).
The findings suggest that a P-DIPS intervention in the hospital setting of Nepal has a significant potential to improve blood pressure, medication adherence and HRQoL in patients with hypertension.
尼泊尔的高血压患者通常存在较差的药物依从性和生活质量。本随机对照试验旨在评估医院药剂师提供的个体化药物服务（P-DIPS）干预对尼泊尔医院环境中高血压患者的血压、药物依从性和健康相关生活质量（HRQoL）的影响。
在一项开放试验中，将 56 名接受降压药物治疗≥6 个月的成年高血压患者随机分为对照组（n=28）和干预组（n=28），对照组接受常规护理，干预组接受常规护理加 P-DIPS。采用 Mann-Whitney U 检验、独立 t 检验或 χ²检验比较两组患者在基线、2 个月和 4 个月时的血压、药物依从性和 HRQoL 差异。
参与者主要年龄≥40 岁（86%），女性（57%）。对照组（C）和干预组（I）的基线特征无显著差异。2 个月时，两组患者的 Morisky-Green-Levine（MGL）药物依从性评分中位数（IQR）（I=1（2） vs C=2（2）；p<0.001）和 HRQoL 心理成分中位数（IQR）（I=43.6（9.5） vs C=37.5（8.6）；p=0.013）均显著改善。4 个月时，两组间所有结局指标的中位数（IQR）值均有显著差异（收缩压：I=125（10）mmHg vs C=130（15）mmHg，p=0.008；舒张压：80（14）mmHg vs 90（10）mmHg，p=0.012；MGL 评分：I=1（1） vs C=2（1），p<0.001；HRQoL 生理成分：45.0（9.0） vs C=40.3（8.2），p=0.046；HRQoL 心理成分：47.1（11.1） vs C=38.8（8.5），p=0.003）。
研究结果表明，尼泊尔医院环境中实施的 P-DIPS 干预具有显著潜力，可改善高血压患者的血压、药物依从性和 HRQoL。
