Amirthalingam, Amirthan Rajakumaran Selliah (2017). An evaluation of a community pharmacy based, pharmacist-led intervention package targeted to the patients’ adherence status, to achieve and maintain target blood pressure (BP) control by optimising antihypertensive medicine adherence. University of Birmingham. Other
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Amirthalingam17DPharm.pdf
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Abstract
Antihypertensive pharmacotherapy is associated with poor adherence. No validated method exists to establish patients’ likely adherence level. A systematic review and a single, Swedish community pharmacy practice-based pilot study were undertaken investigating blood pressure (BP) optimization from pharmacist-led, community pharmacy based antihypertensive adherence interventions titrated to individual patients.
The systematic review showed generic interventions are often used for optimizing BP. Different intervention outcomes vary: positive, negative and no effect has been demonstrated.
Pilot study participants (n=153) were categorised into adherence subgroups (A=Adherent, IR=Intentionally non adherent rational, II=Intentionally non-adherent irrational, U=Unintentionally non-adherent) based on responses to questionnaire format adherence screens. Interventions were designed intuitively to optimize adherence for each subgroup: changes in blood pressure and adherence attitudes were assessed.
A significant reduction in mean systolic BP (SBP) (3 mmHg, P<0.05), with no change in mean diastolic BP (DBP) was seen overall. However, outcomes varied with subgroup: adherence was enhanced in the U subgroup (decreased SBP: 3 mmHg; DBP: no change), but indications of a detrimental effect were observed in the II subgroup (SBP: no change; increased DBP: 3 mmHg).
It is feasible to assign patients to different adherence subgroups in community pharmacy, which may optimize medicines adherence through personalization of interventions.
Type of Work: | Thesis (Other) | ||||||
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Award Type: | Other | ||||||
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College/Faculty: | Colleges (2008 onwards) > College of Medical & Dental Sciences | ||||||
School or Department: | Institute of Clinical Sciences | ||||||
Funders: | None/not applicable | ||||||
Subjects: | R Medicine > RM Therapeutics. Pharmacology | ||||||
URI: | http://etheses.bham.ac.uk/id/eprint/7834 |
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