Abstract
Hypertension is poorly managed. Hospital-based pharmacists working with physicians have been shown to improve the rate of achievement of ‘target’ blood pressure in selected patients. It is unknown if such schemes can operate in the community and to what extent they would attract volunteers with poorly managed blood pressure. We assessed the feasibility of pharmacists to provide community-based, open-access, blood pressure monitoring. In addition, we describe the blood pressure profile of the group in comparison to that of the 1994 Health Survey of England (HSE). Pharmacists from six pharmacies were trained to deliver the service. Adults living within the postal districts of the pharmacies were invited, through an advertising campaign, to volunteer to have their blood pressure measured. Blood pressure data and information on treatment for hypertension and/or diabetes were collected on 263 registrants. Patients were advised to have their blood pressure managed by the general practitioner immediately (category 1), re-measured within 2–3 months (category 2) or in 12 months time (category 3). The mean (s.d.) blood pressure of patients in categories 1 (n = 16), 2 (n = 117) and 3 (n = 130) was 186(16)/97(29), 151(13)/94(9) and 139(22)/86(13) mm Hg respectively; P < 0.001. Ninety-one patients (35%) were in receipt of antihypertensive therapy. Forty-five percent of the treated group had controlled blood pressure (<160/95 mm Hg) compared with 30% in the HSE dataset. A large proportion of known hypertensive patients with poor blood pressure control who had visited their general practitioner within the previous 6 months were detected by the pharmacist-led service. Pharmacists operating an open-access blood pressure monitoring service may be of value in improving the management of hypertension.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 digital issues and online access to articles
$119.00 per year
only $9.92 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Collins R, MacMahon S Blood pressure, antihypertensive drug treatment and the risks of stroke and of coronary heart disease Br Med Bull 1994 50 272–298
SHEP Cooperative Research Group Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension: final results of the Systolic Hypertension in the Elderly Program (SHEP) JAMA 1991 265 3255–3264
Colhoun HM, Dong W, Poulter NR Blood pressure screening, management and control in England; results from the Health Survey for England 1994 J Hypertens 1998 16 747–752
Du X et alCase-control study of stroke and the quality of hypertension control in north west England BMJ 1997 314 272–276
Berlowitz DR et alInadequate management of blood pressure in a hypertensive population N Engl J Med 1998 339 1957–1963
Erickson SR, Slaughter R, Halapy H Pharmacists’ ability to influence outcomes of hypertension therapy Pharmacotherapy 1997 17 140–147
Bogden PE et alComparing standard care with a physician and pharmacist team approach for uncontrolled hypertension J Gen Int Med 1998 13 740–745
O’Brien E, Mee F, Atkins N, Thomas M Evaluation of three devices for self-measurement of blood pressure according to the revised British Hypertension Society Protocol: the Omron HEM-705CP, Philips HP5332, and Nissei DS-175 Blood Press Monit 1996 1 55–61
Ramsay LE et alBritish Hypertension Society guidelines for hypertension management 1999: a summary BMJ 1999 319 630–635
1991 Census Report of Greater London. Part I. Office of Population Censuses and Surveys Stationery Office, London, United Kingdom
National High Blood Pressure Education Program Working Group Report on Primary Prevention of Hypertension Arch Intern Med 1993 153 186–208
Stamler J, Wentworth D, Neaton JD, for the MRFIT Research Group Is the relationship between serum cholesterol and risk of premature death from coronary heart disease continuous and graded? Findings in 356 222 primary screenees of the Multiple Risk Factor Intervention Trial (MRFIT) JAMA 1986 256 2823–2828
O’Connor AM et alDecision aids forpatients facing health treatment or screening decisions: systematic review BMJ 1999 319 731–734
McGhee SM et alCoordinating and standardising long-term care: evaluation of the west of Scotland shared care scheme for hypertension Br J Gen Prac 1994 44 441–445
Acknowledgements
We would like to thank Liz Denver and Alison Holmes for assisting with the blood pressure training programme, and are most grateful to all the pharmacists who voluntarily participated in this pilot study. SW was supported by a research grant from Zeneca Pharmaceuticals. Solvay Healthcare provided support for the purchase of the Omron blood pressure monitors.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Earle, K., Taylor, P., Wyatt, S. et al. A physician-pharmacist model for the surveillance of blood pressure in the community: a feasibility study. J Hum Hypertens 15, 529–533 (2001). https://doi.org/10.1038/sj.jhh.1001220
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.jhh.1001220
Keywords
This article is cited by
-
Views of the Scottish general public on community pharmacy weight management services: international implications
International Journal of Clinical Pharmacy (2012)
-
Evaluation of PROforma as a language for implementing medical guidelines in a practical context
BMC Medical Informatics and Decision Making (2006)
-
Role of community programs in controlling blood pressure
Current Hypertension Reports (2006)
-
Appraisal of the knowledge of hypertensive patients and assessment of the role of the pharmacists in the management of hypertension: results of a regional survey
Journal of Human Hypertension (2005)
-
The hypertension-related organ damage: a poorly perceived danger in subjects with low education
Journal of Human Hypertension (2002)