Increasing Community Pharmacy Involvement in the Prevention of Cardiovascular Disease

Project Details
Project ID: 2007/08-10
Type: Commissioned
Status: Completed
Institution: Monash University
Chief Investigator: Associate Professor Kay Stewart

Project Summary

Poor adherence and lack of persistence with antihypertensive medications are important reasons for failure to achieve target blood pressure (BP). This study tested an intervention package to enable community pharmacists to improve patient adherence and/or persistence with antihypertensive medications with a view to improving BP control.

The six-month randomised controlled trial involved pharmacists and patients from Victoria, Western Australia and Tasmania. Pharmacies were randomised to Pharmacist Care Group (PCG) or Usual Care Group (UCG). A software application (MedeMineCVD) extracted data from the pharmacy dispensing software (FRED Dispense®) to identify potential patient participants. PCG participants (n=207) received the intervention package, which included a BP monitor, training in home BP monitoring, motivational interviewing, education, and refill reminders, whereas UCG participants (n=188) received usual care. A hidden control group (n=178) was used to check for Hawthorne effect. Fifty-five pharmacies (29 in PCG, 26 in UCG) participated.

Patient participants had a mean age of 66.7 ± 11.9 years and 202 (51.1%) were male. There were no significant differences between the groups at baseline. Numbers of participants completing the study were 176 in the PCG and 178 in the UCG.

On the Morisky scale, the proportions of adherent participants in each group increased significantly over six months but the difference between groups was not statistically significant. Significant reduction in systolic BP occurred in both groups (PCG: 9.97 mmHg, p<0.001; UCG: 4.61 mmHg, p<0.01) and was significantly greater in the PCG (p=0.02).

Australian community pharmacists, with appropriate training, assisted consumers with hypertension in achieving target BP.