Pharmacy Implementation Trial: Adherence to Antihypertensive Therapy

Radboud University Medical Center57 enrolled

Overview

The purpose of this study is to determine the effectiveness of maximal support of community pharmacies to implement a pharmaceutical care model for establishing and - if necessary - improving adherence to antihypertensive medication in patients with medication-resistant hypertension.

Cardiovascular disease is the main cause of death in large parts of the world. Hypertension is an important risk factor for cardiovascular disease. Although hypertension treatment has improved in the last decade, the effectiveness of antihypertensive therapy still needs attention. Adherence to medication appears to play an important role in that. Pharmacists can support the general practitioners in their efforts to optimize antihypertensive therapy, by establishing adherence to medication of patients with hypertension in spite of the use of one or more antihypertensive drugs. This is performed with the electronic Medication Event Monitoring System (MEMS®). Registered adherence and accompanying blood pressure are discussed with the patient by the GP. Implementation of the above-mentioned intervention is studied in two randomized groups of pharmacies. One group receives minimal support in the intervention, the other group also receives interactive educational meetings, reminders and feedback, and support of multiprofessional cooperation.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Enrollment

Conditions

Hypertension

Interventions

extensive implementation programmeOTHER

experimental pharmacists follow an extensive implementation programme. They attend two interactive half a day educational meetings tailored to individual needs: one at start of the intervention, and one in May or September 2007. Special attention is given to multiprofessional cooperation with general practitioners and nurse practitioners. Additionally, guided by their own project planning pharmacists receive three or more telephone calls, both as a reminder, feedback, and in order to investigate whether they need any more help.

controlOTHER

pharmacists only receive a written manual with instructions to implement the patient compliance intervention.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * pharmacies: resident in the south of the Netherlands * patients: * 18 years or older * diagnosis of hypertension * systolic blood pressure between 150 and 180 mm Hg despite the use of antihypertensive drug(s) * indication for treatment escalation Exclusion Criteria: * patients: * impossibility to establish blood pressure properly * patient treated by medical specialist * change of antihypertensive therapy because of adverse effects of current medication * insisting on using dose organisers * not managing their drug intake themselves * not able to come to the pharmacy

Outcomes

Primary Outcomes

the number of patients included for intervention

Time frame: 9 months after start of the study

Secondary Outcomes

improvement of systolic blood pressure

Time frame: 2 and 5 months after inclusion

treatment escalation of patients after inclusion into the study

Time frame: 5 months after inclusion

the percentage of GP's in PTAM that cooperates in the intervention

Time frame: 9 months after start of the study

Data from ClinicalTrials.gov

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