Board # 3-356
Uncontrolled hypertension is one of the largest risk factors and predictors of major cardiovascular events. There are several ways for the general public to have their blood pressure checked, but many people do not know how to interpret their results. It is thought that 1/3 of adults in the United States has hypertension, and many go undiagnosed. Since the new JNC-8 guidelines have come out, there has been much controversy and confusion because some healthcare providers still follow JNC-7. It is important for pharmacists as well as student pharmacists to help bridge the gap between health care providers and patients to keep them up to date with their goals.
Investigate the importance of interaction between a student pharmacist and patients in an ambulatory care setting to screen and counsel on hypertension and medications used for its management.
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A national chain pharmacy gave permission to set up a blood pressure screening site once weekly for 12 weeks.
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Patients were offered a free blood pressure reading along with individualized counseling.
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Advertisements were created and distributed.
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Patients voluntarily sat down with a student pharmacist to receive the service.
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Student pharmacist created a patient questionnaire to test general knowledge on hypertension and gather information.
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Counseling sessions were individualized based on results.
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After 1-3 minutes, patient’s blood pressure was taken and recorded.
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Materials such as BP logs and DASH diet information were provided to each patient.
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Counseling included adherence, proper administration, and general facts about hypertension.
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Some patients were referred to their primary care physician.
Blood Pressure Quiz/Questionnaire
1. What is a normal blood pressure reading for an adult? __ ___
2. Throwing away table salt is the only way to lower Sodium intake. T/F
3. People can have high blood pressure and not know it. T/F
4. It does not matter what time I take my blood pressure medication each day, as long as I remember to take it at some point. T/F
5. Once your blood pressure is back to normal, you can stop taking your medication. T/F
6. High blood pressure that goes untreated can put a person at a greater risk for heart attack or stroke. T/F
I am currently on ____ medications for High Blood Pressure
BP Reading:
123 patients were screened over a 12-week period
Data was collected and stratified depending on the number of medications currently being used to control blood pressure
Question # % Correct
1
2
11%
84%
5
6
3
4
94%
83%
89%
100%
Question # % Correct
1
2
3
4
44%
73%
100%
80%
5
6
100%
93%
Question # % Correct
1
2
43%
81%
5
6
3
4
95%
80%
90%
100%
Question # % Correct
1 30%
2
3
71%
100%
4
5
6
71%
100%
100%
Question # % Correct
1
2
32%
79%
5
6
3
4
97%
80%
93%
98%
Provided valuable free education to patients
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Provided a great platform for pharmacist-patient interaction on hypertension management.
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People who would not normally seek medical help were able to receive important information.
Helped identify several patients in possible need of hypertension medication
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Nearly 20% of patients not diagnosed with high blood pressure had readings that were above normal.
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One elevated reading is not diagnostic, but all patients were referred to their doctor with a written note.
Showed importance of staying up to date with the Hypertension Guidelines
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The majority of patients did not understand or know their goal blood pressure.
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The differences in blood pressure goals between JNC-7 and JNC-8 had caused some confusion for patients and health care practitioners.
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It is critically important that pharmacists work with patients to help them understand the JNC-8 Guidelines
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Pharmacists and student pharmacists can help patients learn and achieve their individual blood pressure goal.
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Allow pharmacists and patients to work together and manage hypertension in a clinic setting.
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Create a study to look at the effect of splitting blood pressure medications into morning and evening doses in hopes for better around the clock control (based on published studies).
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Other medications that can affect blood pressure readings were not considered.
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Only a single goal was considered in results.
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Blood pressure may have been falsely elevated due to exogenous factors such as:
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Not having adequate rest time before having blood pressure tested
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Unknown acute stress