Vol 15, Issue 5, 2022 Online - 2455-3891 Print - 0974-2441 IMPACT OF PHARMACIST LED HYPERTENSION MANAGEMENT ANJU SARAH MATHEWS*, SRESHI KUMARI ABSTRACT Objective: The study objective was to analyze the effect of pharmacist interventions in improving blood pressure control. Methods: The prospective interventional study was conducted on a population who were known hypertensive for more than 2 years. They were randomly categorized into two groups, interventional group and usual care group. Pharmaceutical care, involving telephonic follow-up, adherence analysis, patient education was given in the former group in a time interval of 2 months for about 12 months while the later was on regular therapeutical care only. Blood pressure was monitored in each follow-up. The difference in control of blood pressure was measured in terms of mm/Hg unit. The improvement in the measure from start and end of the study was analyzed within the group and between the groups. Results: Lowered blood pressure was observed in both the groups in the end of study. But statistically significant difference was seen in interventional group compared to the other. Involvement of pharmacist led care helped in achievement of AHA goal. Conclusions: Including clinical pharmacist in a health-care team can provide unerring therapeutic regimen to patients thereby their health-care outcome. Keywords: Hypertension, Medication adherence, Clinical pharmacist, Pharmaceutical care, Patient education, Patient counseling, Intervention. INTRODUCTION Hypertension has become a common chronic disease that needs continuous monitoring and treatment throughout a lifetime [1,2]. Most of the cases remain diagnostic until any complications evolve [3,4]. Hypertension is attributable as the risk factor for cardiovascular disease, heart failure, renal failure, and stroke [5,6]. In India, the incidence of hypertension is increasing hastily, especially in urban areas. Change in lifestyle and diet along with poor awareness and control is regarded as main factors that are influencing the emergence of the condition in high rate [7]. It was established that blood pressure could be managed by exhaustive interventions. Control on blood pressure can be achieved only by blending therapeutic regimen along with the life style modification that can be attained by proper patient education and continuous follow-up. Mostly elderly people may have comorbid conditions and will be on multiple drug therapy which we call as a complicated regimen which will be difficult for the patients to stick up on [8]. Medication adherence is the key for execution of proper drug effect. Noncompliance to the regimen and to the diet plan will lead to complications associated with chronic disorder that may lead to irreversible damage to the organs associated with it [9]. Cardiovascular disease, renal disease, and neurological deficit are some of it [10]. Even though antihypertensive therapy reduces the risk for cardiovascular disease, a large population of the hypertensive patients were found not treated or insufficiently treated due to the absence of proper compliance with the medications [11]. In general, the antihypertensive treatment fails due to factors like the disease are symptomless in nature, long duration of therapy, complicated regimens, side effects, and above all, lack of knowledge and understanding about the disease and its complications and medication management. Polypharmacy is one of the soul causes of medication noncompliance as well as drug interaction. Together with these obstacles, literacy, poor knowledge about the disease conditions and treatments, and lack of social support become barrier in achieving the target goal of hypertensive management [12]. Interventions focusing on improving the awareness regarding the disease, various specific therapies its problems and the need for adherence turn beneficial [13]. Clinical pharmacists were introduced into the care team mainly to satisfy these objectives [14]. It has been reported that interventions by the pharmacists produced a strong impact on the adherence and improved antihypertensive treatment outcomes. Ongoing and regular follow-up is the only way that can contribute and can be accomplished by rational involvement of pharmacist in patient care [15]. The main objective of the study was to find out the tweak in management of hypertension by the involvement of clinical pharmacist in patient care team [16]. METHODS Prospective study was conducted for over a year period after acquiring approval from institutional ethic committee. (Approval no: JMCP/IEC-01A/PD-2018). Patients who were known hypertensive and on treatment for more than 2 years were selected for the study. Exclusion criteria included those who had hepatic and renal disorders or any other critical illness. The patient between 18 years and 70 year of age was selected for the study regardless of the gender. After obtaining informed consent from the participants, they were randomly categorized into two groups, interventional group and control group. Interventional group patients were given special care by a clinical pharmacist in addition to the regular therapy while control group was on usual care. The intervention group patients were given detailed information about the steps in conduct of study. It involved a multifaceted face to face interview about their disease, medication, regimen, possible side effects, need for adherence, diet control, and exercise. In the beginning of study, for both groups medication adherence level was analyzed using medication adherence rating scale (MARS), the knowledge assessment was done based on QOL questionnaire and the blood pressure was monitored and recorded. In every follow-up period blood pressure was recorded for usual care group while interventional group was on constant observation by the pharmacist. In 12 months, study period every alternative month, follow-up was recommended and all the data © 2022 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (http://creativecommons.org/ licenses/by/4.0/) DOI: http://dx.doi.org/10.22159/ajpcr.2022v15i5.43630. Journal homepage: https://innovareacademics.in/journals/index.php/ajpcr Research Article Department of Krupanidhi College of Pharmacy, Bengaluru, Karnataka, India. Email: anjuz12@gmail.com Received: 16 November 2021, Revised and Accepted: 20 April 2022