Community Pharmacist Practices in Hypertension Management

Abstract

Objective:

To determine the current practices of community pharmacists in the management of hypertension.

Methods:

This was a cross-sectional, observational study of pharmacist practice using unannounced standardized patients (SPs) with hypertension visiting a random stratified sample of 101 community pharmacies in Edmonton, Alberta. Consent was not obtained from pharmacists.

Results:

Knowledge of current blood pressure guidelines and target values: Of the 101 community pharmacists who were visited by the SPs, 69% offered a general blood pressure target value (<120/80 mm Hg); only 7% stated the correct target blood pressure value for the SPs' particular scenario (<140/90 mm Hg). Only 14% requested enough patient history to properly determine target blood pressure. Review of medical history: Few pharmacists questioned the SPs about their medical history (7%), medication profile (16%), family history of cardiovascular disease (19%), previous elevated blood pressure readings (20%), or previous diagnosis of hypertension (22%). Accuracy/confirmation of blood pressure reading: 53% of pharmacists inquired about the conditions under which the blood pressure reading had been taken; 39% of pharmacists offered to retake the patient's blood pressure. Patient education: Pharmacists discussed how hypertension is diagnosed (76%), what hypertension is (46%), how to take a blood pressure reading properly (46%), and the impact of lifestyle measures on blood pressure (60%); they also gave supplemental educational materials (29%). Referral: 83% of pharmacists advised the SPs to make an appointment to see a physician.

Conclusions:

Pharmacists took reasonable steps to determine the accuracy of the blood pressure measurement, explain the diagnosis of hypertension, and refer to a physician. Major deficiencies were observed in assessment of target blood pressure and review of medical history. Pharmacists, alone or in collaboration with other health professionals, are urgently needed to play a major role in identifying, screening, and managing individuals with hypertension. Can Pharm J 2006;139(5):38–44.

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