Key result
A hospital pharmacist-delivered individualised pharmaceutical service significantly improved median systolic blood pressure at 4 months compared to usual care (125 vs 130 mmHg; p=0.008).
Why the study?
Patients with hypertension in Nepal often experience poor medication adherence and quality of life.
Does a hospital pharmacist-delivered individualised pharmaceutical service improve blood pressure, medication adherence, and health-related quality of life in adult patients with hypertension?
RCT (n=56)
Open-label
Randomly allocated
No
Does a hospital pharmacist-delivered individualised pharmaceutical service improve blood pressure, medication adherence, and health-related quality of life in adult patients with hypertension?
A pharmacist-delivered individualized pharmaceutical service significantly improves blood pressure control, medication adherence, and quality of life in hypertensive patients.
Answers are grounded in this paper and cite their sources.
Supports pharmacist integration into hypertension care; confirms individualized services improve systolic blood pressure in RCTs.
Objectives 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. Methods 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 χ² tests. Results 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). Conclusions 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.
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Paudel et al. (2022) conducted an RCT in Hypertension (n=56). Hospital pharmacist-delivered individualised pharmaceutical service (P-DIPS) vs. Usual care was evaluated on Systolic blood pressure at 4 months (p=0.008). A hospital pharmacist-delivered individualised pharmaceutical service significantly improved median systolic blood pressure at 4 months compared to usual care (125 vs 130 mmHg; p=0.008).
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