Consejería farmacéutica y adherencia al tratamiento antihipertensivo: estudio preliminar

Abstract

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: 7.0-13.0; 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: 1.13-9.02 mm Hg; p=0.012) and of 14.7 mm Hg in the CG and of 20.95 mmHg in the IG (95% CI: 2,12-10,02 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: 0.57-6,73 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 0.04-5.07 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. © 2009 SEHLELHA.