Community Pharmacy-Based Hypertension Disease-Management Program in a Latino/Hispanic-American Population

OBJECTIVE: To evaluate if the community, pharmacy-based hypertension disease-management (DM) program significantly improved patient's clinical outcomes and health-related quality of life (HRQOL) in a Latino/Hispanic-American community. DESIGN: Quasi-experimental time-series study. SETTINGS: The study was implemented at two primary-care clinics in health maintenance organizations and two community pharmacy settings located in South Florida. PARTICIPANTS: Patients who have a long-term history of uncontrolled hypertension were identified and referred by their primary care physicians. INTERVENTION: A nine-month, community pharmacy-based hypertension disease-management program. MAIN OUTCOME MEASURES: HRQOL was assessed via SF-12 questionnaire and analyzed by norm-based scoring methods. Wilcoxon signed rank tests with 0.05 alpha levels were used to compare the differences in systolic blood pressure (SBP)/diastolic BP (DBP), medication compliance, and frequency of BP screenings between baseline and endpoint of the intervention. RESULTS: A total of 53 patients (50.5%) completed the program. SBP/DBP significantly declined from 150.5/95.5 mmHg to 133.8/83.3 mmHg on the second month and remained consistent throughout the study period. Quality of life and mental component summary/physical component summary scores slightly increased from 48.58/46.68 to 50.39/51.51. The number of patients monitoring BP at home and medication compliance also significantly increased after nine months of intervention. CONCLUSIONS: The key factor in accomplishing this DM program is meeting the health care needs of a unique population-the Hispanic-American community. Clinicians, administrators, and public health officials should note that understanding the broad parameters of a culture is essential to providing quality care to individuals, families, and communities.