PURPOSE: Verification of whether pharmacotherapeutic follow-up improves arterial blood pressure (BP) was conducted, and whether this improvement alters the quality of life of patients with resistant hypertension in a university teaching hospital in Brazil was determined. METHODS: A prospective survey of 44 patients was carried out over a period of 20 months. Each patient was followed up for 12 months. Pharmaceutical care was assessed using the following methods: measurement of the office BP and ambulatory BP monitoring, adherence to therapy, drug-related problems, and the use of health care facilities (urgent care visits and hospital admissions). The health-related quality of life (HRQOL) of patients was also assessed using the 36-Item Short Form Health Survey (SF-36) questionnaire and a physical symptoms profile. RESULTS: The majority (95.5%) of patients adhered to the treatment throughout the study, and there was a significant reduction in BP (p < 0.05). Nearly all of the domains of HRQOL assessed by SF-36 remained unchanged during the follow-up except for a significant improvement in social functioning (p = 0.041). There was a significant reduction in moderate and severe physical symptoms (p = 0.005). There were also significant reductions in the number of urgent care visits (p = 0.0001) and hospital admissions (p = 0.006). CONCLUSION: The pharmaceutical care provided by a pharmacist in an ambulatory care clinic in Brazil improved BP, adherence to antihypertensive medications, and the social functioning of patients with resistant hypertension.
PURPOSE: Verification of whether pharmacotherapeutic follow-up improves arterial blood pressure (BP) was conducted, and whether this improvement alters the quality of life of patients with resistant hypertension in a university teaching hospital in Brazil was determined. METHODS: A prospective survey of 44 patients was carried out over a period of 20 months. Each patient was followed up for 12 months. Pharmaceutical care was assessed using the following methods: measurement of the office BP and ambulatory BP monitoring, adherence to therapy, drug-related problems, and the use of health care facilities (urgent care visits and hospital admissions). The health-related quality of life (HRQOL) of patients was also assessed using the 36-Item Short Form Health Survey (SF-36) questionnaire and a physical symptoms profile. RESULTS: The majority (95.5%) of patients adhered to the treatment throughout the study, and there was a significant reduction in BP (p < 0.05). Nearly all of the domains of HRQOL assessed by SF-36 remained unchanged during the follow-up except for a significant improvement in social functioning (p = 0.041). There was a significant reduction in moderate and severe physical symptoms (p = 0.005). There were also significant reductions in the number of urgent care visits (p = 0.0001) and hospital admissions (p = 0.006). CONCLUSION: The pharmaceutical care provided by a pharmacist in an ambulatory care clinic in Brazil improved BP, adherence to antihypertensive medications, and the social functioning of patients with resistant hypertension.
Authors: Ashna D K Bowry; William H Shrank; Joy L Lee; Margaret Stedman; Niteesh K Choudhry Journal: J Gen Intern Med Date: 2011-08-20 Impact factor: 5.128