Managing Medication Adherence in Elderly Hypertensive Patients Through Pharmacist Home Visits

Consult Pharm. 2015 Dec;30(12):710-9. doi: 10.4140/TCP.n.2015.710.

Abstract

Objective: The purpose of the Managing Your Blood Pressure program was to reduce health disparities in blood pressure (BP) control by improving medication adherence in a cohort of geriatric African-Americans with hypertension (HTN).

Design: The program was implemented using a quasi-experimental pre- and postintervention study design that utilized a pharmacist home-based model and follow-up educational phone calls to impact BP over a six-month period.

Setting: Home visits occurred in participants' residences, and phone calls occurred at program headquarters at Texas Southern University (Houston, Texas).

Main outcome measures: The primary outcome measure was BP control rate, and secondary outcome measures were knowledge of HTN, medication adherence, and use of a BP monitor.

Results: At six months, 306 of the 431 patients recruited completed all phases of the program (two in-home consultations and biweekly telephone consultations). At the end of the six-month intervention period, the reduction in mean systolic BP was statistically significant (baseline 140 mmHg vs. six months 137 mmHg; P < 0.049). No difference in mean diastolic BP pre- and postintervention was found. The percent of patients with controlled BP improved from 46.7% to 49.5%; P = 0.34. Medication adherence, self-monitoring of BP, and knowledge of HTN were significantly improved from baseline to postintervention.

Conclusion: Pharmacist-led interventions in the home were effective in improving BP control and medication adherence. Further programs are needed to address uncontrolled HTN in this vulnerable population.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents / administration & dosage*
  • Antihypertensive Agents / therapeutic use
  • Black or African American
  • Blood Pressure / drug effects
  • Female
  • Follow-Up Studies
  • Health Knowledge, Attitudes, Practice
  • Health Status Disparities
  • Home Care Services / organization & administration
  • Humans
  • Hypertension / drug therapy*
  • Male
  • Medication Adherence*
  • Medication Therapy Management / organization & administration
  • Pharmaceutical Services / organization & administration
  • Pharmacists / organization & administration*
  • Pilot Projects
  • Treatment Outcome

Substances

  • Antihypertensive Agents