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American Journal of Health-System Pharmacy, Vol. 64, Issue 18, 1955-1961
Copyright © 2007 by American Society of Health-System Pharmacists
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American Journal of Health-System Pharmacy, Vol. 64, Issue 18, 1955-1961
Copyright © 2007. American Society of Health-System Pharmacists, Inc. All rights reserved. 1079-2082/04/0602-1242$06.00


Notes

Effect of pharmaceutical care on blood pressure control and health-related quality of life in patients with resistant hypertension

Walnéia Aparecida de Souza, Juan Carlos Yugar-Toledo, Gun Bergsten-Mendes, Maricene Sabha and Heitor Moreno, Jr.

WALNEIA APARECIDA DE SOUZA, B.PHARM., M.Sc., is Assistant Professor, Department of Pharmacy, Federal University of Alfenas, Alfenas, MG, Brazil, and Doctoral Student, Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil. JUAN CARLOS YUGAR-TOLEDO, M.D., M.SC., PH.D., is Cardiologist, Cardiovascular Pharmacology Laboratory, Department of Pharmacology; GUN BERGSTEN-MENDES, M.D., PH.D., is Associate Professor of Pharmacoepidemiology and Clinical Pharmacology, Department of Pharmacology; MARICENE SABHA, PHARM.D., M.SC., PH.D., is Researcher in Clinical, Cardiovascular Pharmacology Laboratory, Department of Pharmacology; and HEITOR MORENO JR., M.D., M.SC., PH.D., is Professor, Cardiovascular Pharmacology Laboratory, Department of Pharmacology, Faculty of Medical Sciences, UNICAMP.

Address correspondence to Ms. de Souza at the Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas, P.O. Box 6111, 13081-970, Campinas, SP, Brazil (walne23{at}yahoo.com.br).


Purpose. Verification of whether pharmacotherapeutic follow-up improves arterial blood pressure (BP) was conducted, and whether this improvement alters the quality of life of patients with resistant hypertension in a university teaching hospital in Brazil was determined.

Methods. A prospective survey of 44 patients was carried out over a period of 20 months. Each patient was followed up for 12 months. Pharmaceutical care was assessed using the following methods: measurement of the office BP and ambulatory BP monitoring, adherence to therapy, drug-related problems, and the use of health care facilities (urgent care visits and hospital admissions). The health-related quality of life (HRQOL) of patients was also assessed using the 36-Item Short Form Health Survey (SF-36) questionnaire and a physical symptoms profile.

Results. The majority (95.5%) of patients adhered to the treatment throughout the study, and there was a significant reduction in BP (p < 0.05). Nearly all of the domains of HRQOL assessed by SF-36 remained unchanged during the follow-up except for a significant improvement in social functioning (p = 0.041). There was a significant reduction in moderate and severe physical symptoms (p = 0.005). There were also significant reductions in the number of urgent care visits (p = 0.0001) and hospital admissions (p = 0.006).

Conclusion. The pharmaceutical care provided by a pharmacist in an ambulatory care clinic in Brazil improved BP, adherence to antihypertensive medications, and the social functioning of patients with resistant hypertension.

Index terms: Ambulatory care; Compliance; Data collection; Hospitals; Hypertension; Interventions; Patients; Pharmaceutical care; Pharmacists; Quality of life; Toxicity

 






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