• 作者：A. Torres ; ^{projectes@cofb.net} ; B. Fité ; P. Gascó ; n ; M. Barau ; R. Guayta-Escolies ; M. Estrada-Campmany ; C. Rodrí ; guez
• 关键词：Hipertensió ; n ; Farmacia comunitaria ; Atenció ; n farmacé ; utica ; Incumplimiento ; Problemas relacionados con el medicamento
• 刊名：Hipertensi贸n y Riesgo Vascular
• 出版年：2010
• 期刊代码：pca183_18891837
• 类别：med
• 出版时间：January-February 2010
• 卷：27
• 期：1
• 页码：13-22
• 文件大小：285 K

Introduction

Pharmaceutical care activities provide a resource to increase the degree of control in chronic disease patients. This study has aimed to evaluate the efficacy of a community pharmaceutical intervention in treated hypertensive patients with poor control of the blood pressure (BP).

Material and methods

This was an experimental, longitudinal, prospective, randomized and unmasked study conducted in 102 community pharmacies. A total of 461 patients whose high blood pressure was not controlled were equally assigned to an intervention group (IG) in which a validated follow-up protocol was applied and to a control group (CG). The percentage of controlled patients, degree of compliance, mean decrease in blood pressure values and number of drug-related problems (DRP) detected and corrected were evaluated.

Results

After adjusting for age, gender and study level, the degree of control at 3 months of follow-up was 27%in the CG and 37.2%in the IG (95%CI: 7.0鈥?3.0; p=0.03). At 6 months, it reached 38.3%in the CG and 55.2%in the IG GI (p=0.001).

The SBP values at 3 and 6 months experienced a mean decrease of 11.0 mm Hg in the CG and of 16.08 mmHg in the IG (95%CI: 1.13鈥?.02 mm Hg; p=0.012) and of 14.7 mm Hg in the CG and of 20.95 mmHg in the IG (95%CI: 2,12鈥?0,02 mm Hg; p=0.003) respectively.

Decrease of the DBP at 3 and 6 months was 4.76 mm Hg in the CG and 8.40 mmHg in the IG (95%CI: 0.57鈥?,73 mm Hg; p=0.021), and a mean of 4.92 mm Hg in the CG and 7.48 mmHg in the IG (95%CI 0.04鈥?.07 mm Hg; p=0.046), respectively.

There are significant differences in the percentage of compliers in the intervention group between the onset of the study, which was 69 patients (30%) and the end of the intervention when it was 141 patients (60.8%) (p=0.01). There is a weak significant correlation with the number of visits (r=0.26). A total of 247 DRP were detected in 70%of the patients, which represents a mean of 1.93 DRP per patient.

Conclusions

Pharmaceutical care in poorly controlled hypertensive patients is associated to an increase in the level of control and treatment adherence and better detection and correction of DRP.