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Title: An evaluation of a community pharmacy based, pharmacist-led intervention package targeted to the patients' adherence status, to achieve and maintain target blood pressure (BP) control by optimising antihypertensive medicine adherence
Author: Amirthalingam, Amirthan Rajakumaran Selliah
ISNI:       0000 0004 6493 7409
Awarding Body: University of Birmingham
Current Institution: University of Birmingham
Date of Award: 2017
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Antihypertensive pharmacotherapy is associated with poor adherence. No validated method exists to establish patients’ likely adherence level. A systematic review and a single, Swedish community pharmacy practice-based pilot study were undertaken investigating blood pressure (BP) optimization from pharmacist-led, community pharmacy based antihypertensive adherence interventions titrated to individual patients. The systematic review showed generic interventions are often used for optimizing BP. Different intervention outcomes vary: positive, negative and no effect has been demonstrated. Pilot study participants (n=153) were categorised into adherence subgroups (A=Adherent, IR=Intentionally non adherent rational, II=Intentionally non-adherent irrational, U=Unintentionally non-adherent) based on responses to questionnaire format adherence screens. Interventions were designed intuitively to optimize adherence for each subgroup: changes in blood pressure and adherence attitudes were assessed. A significant reduction in mean systolic BP (SBP) (3 mmHg, P < 0.05), with no change in mean diastolic BP (DBP) was seen overall. However, outcomes varied with subgroup: adherence was enhanced in the U subgroup (decreased SBP: 3 mmHg; DBP: no change), but indications of a detrimental effect were observed in the II subgroup (SBP: no change; increased DBP: 3 mmHg). It is feasible to assign patients to different adherence subgroups in community pharmacy, which may optimize medicines adherence through personalization of interventions.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Pharm.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: RM Therapeutics. Pharmacology