Medication Adherence and Beyond: Blood Pressure Control and the Pharmacist

2011 marked the 12th year in which the Canadian Hypertension Education Program (CHEP) released annual guidelines for the diagnosis and treatment of hypertension, and the 6th year that a targeted pharmacist version of these guidelines has been developed.1 The latest versions of the guidelines emphasize the important role of adherence to both medication and lifestyle strategies. The pharmacist-specific recommendation in the CHEP guidelines indicates: “Health care professional interventions can reduce nonadherence and improve adherence in those who are having problems. Integrating pharmacists into the care of people with hypertension improves blood pressure control.”2 Assessing adherence and intervening when poor adherence is noted are important elements of pharmaceutical care. As pharmacists, we understand the complexity of adherence and the multiple factors that play a role in helping patients initiate and/or maintain a behaviour change, including lifestyle or use of medications. Communication is necessary to identify and understand whether our patients will follow through with the recommended behavioural change, and the relationship that exists between the pharmacist and the patient may play a role in honest communication, thus affecting adherence either positively or negatively. Since adherence to antihypertensives has been shown to decrease hospitalization rates, offsetting medication costs for this chronic condition,3 it is a vital area for pharmacist involvement.