Hipertansiyonda uyum ve hastalık algısına eczacı katkısının değerlendirilmesi: Gözlemsel bir çalışma
Abstract
Amaç: Hipertansiyon (HT) yüksek kan basıncıyla karakterize, birçok komplikasyona neden olabilen kronik bir hastalıktır. Eczacılar sundukları farmasötik bakım hizmetiyle HT hastalarının yaşam kalitelerine ve tedavi başarılarına katkı sağlayabilirler. Çalışmamızın amacı eczacı tarafından sunulan farmasötik bakım hizmetinin HT hastalık algısına ve tedavi uyumlarına etkilerinin incelenmesidir.
Yöntemler: Çalışmamız Haziran-Aralık 2020 tarhileri arasında invaziv olmayan, prospektif, gözlemsel bir çalışma olarak, İstanbulda bulunan bir serbest eczaneye başvuran HT hastalarının katılımıyla yapılmıştır. Birinci görüşmede katılımcıların, demografik verileri, hastalık algıları ve uyum düzeyleri ölçülmüştür. Birinci görüşme sonunda katılımcılara eczacı tarafından yapılandırılmış yazılı ve sözlü hasta eğitimi verilmiştir. Eczacını sunduğu eğitimin etkileri 90 gün sonra yapılan ikinci görüşmede tekrar ölçülmüştür. Eczacının sunmuş olduğu hizmetlerin üç ay ara ile yapılan iki görüşme sonrasında etkilerini incelemek amacıyla Hastalık Algısı Ölçeği ve Morisky Green Levine tedavi uyum ölçeği kullanılmıştır.
Bulgular: Çalışmaya dahil edilen 75 hastanın 48’i (%64) kadın ve yaş ortalaması 59,68 ± 10,79’tur. Katılımcıların çoğunluğunun (55, %73,32) ortaokul ve altı eğitim düzeyine sahip olduğu ve 58 (%77,33)’inin çalışmadığı kaydedilmiştir. Hipertansiyonla geçirilen ortalama sürenin 11,48 ± 7,24 yıl olarak kaydedildiği örneklemimizde en sık reçetelenen antihipertansif ilaç grubunun diüretikler olduğu göze çarpmaktadır. Eczacı tarafından sunulan farmasötik bakım hizmeti sonrasında katılımcıların hastalık algısının tüm alt boyutlarında istatiksel olarak anlamlı düzeyde farklılık görülmüştür (p<0,05). Katılımcıların uyum düzeyleri eczacı müdahalesi sonrasında %79,75’ten %90.75'e yükselmiştir (p<0,05).
Sonuç: HT hastalarında hastalık algısının ve uyumun artması tedavi başarısına ve yaşam kalitesine olumlu etkileri olduğu literatürde mevcuttur. Çalışmamızda eczacı tarafından sunulan farmasötik bakım hizmetinin etkileri gösterilmiştir. Sonuç olarak hastaların yaşam kalitesini arttırmak için klinik eczacının sunudğu hizmetlere ihtiyaç vardır.
Supporting Institution
Bu makale ile ilgili herhangi bir finansal kaynaktan yararlanılmamıştır.
Project Number
Yok
Thanks
Yazarlar Bezmialem Vakif Üniversitesine sunduğu olanaklardan ötürü teşekkür eder.
References
- World Health Organization (WHO). Cardiovascular diseases (CVDs). Key facts; 2019. Access date June 25, 2023. Available from: https://www.who.int/newsroom/factsheets/detail/cardiovascular-diseases.
- Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. J Am Coll Cardiol. 2018;71(19):e127–e248.
- Mills KT, Bundy JD, Kelly TN, et al. Global disparities of hypertension prevalence and control: a systematic analysis of population-based studies from 90 countries. Circulation. 2016;134:441–50.
- Unger T, Borghi C, Charchar F, et al. 2020 International Society of Hypertension global hypertension practice guidelines. Hypertension. 2020;75(6):1334–57.
- Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). Eur Heart J. 2018;39(33):3021–04.
- Rahayu SA, Widianto S, Defi IR, Abdulah R. Role of Pharmacists in the Interprofessional Care Team for Patients with Chronic Diseases. J Multidiscip Healthc. 2021;14:1701–10.
- Lama S, Souraya D, Youssef F. Statin prescription strategies and atherogenic cholesterol goals attainment in Lebanese coronary artery disease patients. Int J Clin Pharm. 2017;39:919–26.
- Drug Store News. Rx impact: a drug store news special report; 2016: 23. Accessed January 25, 2023. Available from: https://www.nacds.org/pdfs/DSN_RxIMPACT2016.pdf.
- Tsuyuki RT, Al Hamarneh YN, Jones CA, Hemmelgarn BR. The effectiveness of pharmacist interventions on cardiovascular risk: the multicenter randomized controlled RxEACH trial. J Am Coll Cardiol. 2016;67:2846–54.
- Cheema E, Sutcliffe P, Singer DRJ. The impact of interventions by pharmacists in community pharmacies on control of hypertension: a systematic review and metaanalysis of randomized controlled trials. Br J Clin Pharmacol. 2014;78:1238–47.
- Baah-Nyarkoh E, Alhassan Y, Dwomoh AK, Kretchy IA. Medicated-related burden and adherence in patients with co-morbid type 2 diabetes mellitus and hypertension. Heliyon. 2023;9(4):e15448.
- Marfo AFA, Owusu-Daaku FT. Exploring the role of pharmacists in improving blood pressure control among hypertensive patients at the workplace. Sci Afr. 2021;14:e00983.
- Wagner TD, Jones MC, Salgado TM, Dixon DL. Pharmacist’s role in hypertension management: a review of key randomized controlled trials. J Hum Hypertens. 2020;34(7):487–94.
- Di Palo KE, Kish T. The role of the pharmacist in hypertension management. Curr Opin Cardiol. 2018;33(4):382–7.
- Omboni S, Sala E. The pharmacist and the management of arterial hypertension: the role of blood pressure monitoring and telemonitoring. Expert Rev Cardiovasc Ther. 2015;13(2):209–21.
- Vo TH, Charpiat B, Catoire C, et al. Tools for assessing the potential significance of pharmacist interventions: a systematic review. Drug Saf. 2016;39:131–46.
- Whelton PK, Einhorn PT, Muntner P, et al. Research needs to improve hypertension treatment and control in African Americans. Hypertension. 2016;68:1066–72.
- Kara E, Kelleci Çakır B, Sancar M, Demirkan K. Impact of Clinical Pharmacist-led Interventions in Turkey. Turk J Pharm Sci. 2021;18(4):517-26.
- Al-Taie A, Izzettin FV, Sancar M, Köseoğlu A. Impact of clinical pharmacy recommendations and patient counselling program among patients with diabetes and cancer in outpatient oncology setting. Eur J Cancer Care (Engl). 2020;29(5):e13261
- Armay Z, Özkan M, Kocaman N, Özkan S. “Hastalık Algısı Ölçeğinin Türkçe uyarlamasının geçerlilik ve güvenilirlik çalışması.” Adli Psikiyatr. Derg., 2017;8: 271–80.
- Morisky DE, Green LW, Levine DM. Concurrent and Predictive Validity of a Self-Reported Measure of Medication Adherence and Long-Term Predictive Validity of Blood Pressure Control. Med Care 1986;24(1):67-74.
- Patel RP, Taylor SD. Factors affecting medication adherence in hypertensive patients. Ann Pharmacother. 2002;36(1):40-5.
- Aguiar PM, Balisa-Rocha BJ, Brito Gde C, da Silva WB, Machado M, Lyra DP Jr. Pharmaceutical care in hypertensive patients: a systematic literature review. Res Social Adm Pharm. 2012;8(5):383-96.
- Boyé F, Sallerin B, Ah Kang F, et al. Place du pharmacien clinicien dans la prise en charge thérapeutique du patient hypertendu [Place of clinical pharmacist in the management of drugs in patients with hypertension]. Ann Cardiol Angeiol (Paris). 2015;64(3):216-21.
- Hedegaard U, Kjeldsen LJ, Pottegård A, et al. Improving Medication Adherence in Patients with Hypertension: A Randomized Trial. Am J Med. 2015;128(12):1351-61.
- Cheema E, Sutcliffe P, Weickert MO, Singer DRJ. A randomised controlled trial of the impact of structured written and verbal advice by community pharmacists on improving hypertension education and control in patients with high blood pressure. Eur J Clin Pharmacol. 2018;74(11):1391-5.
- McKenney JM, Slining JM, Henderson HR, Devins D, Barr M. The effect of clinical pharmacy services on patients with essential hypertension. Circulation. 1973;48(5):1104–11.
- Mehos BM, Saseen JJ, MacLaughlin EJ. Effect of pharmacist intervention and initiation of home blood pressure monitoring in patients with uncontrolled hypertension. Pharmacotherapy. 2000;20(11):1384–9.
- Ni Y, Chen Y. The effect of pharmaceutical care programs on blood pressure control in individuals with hypertension: a meta-analysis. J Pharm Technol. 2009;25(5):292–6
- Magadza C, Radloff SE, Srinivas SC. The effect of an educational intervention on patients’ knowledge about hypertension, beliefs about medicines, and adherence. Res Social Adm Pharm. 2009;5(4):363–75.
- Peters KF, Horne R, Kong F, Francomano CA, Biesecker BB. Living with Marfan syndrome II. Medication adherence and physical activity modification. Clin Genet. 2001;60(4):283–92.
- Viswanathan H, Anderson R, Thomas J. Evaluation of an antiretroviral medication attitude scale and relationships between medication attitudes and medication nonadherence. AIDS Patient Care STDS. 2005;19(5):306–16..
- Chabot I, Moisan J, Grégoire J-P, Milot A. Pharmacist intervention program for control of hypertension. Ann Pharmacother. 2003;37(9):1186–93.
- Saleem F, Hassali MA, Shafie AA, et al. Pharmacist intervention in improving hypertension-related knowledge, treatment medication adherence and health-related quality of life: a non-clinical randomized controlled trial. Health Expect. 2015;18(5):1270–81.
- Ross S, Walker A, MacLeod MJ. Patient compliance in hypertension: role of illness perceptions and treatment beliefs. J Hum Hypertens. 2004;18(9):607–13.
- Horne R, Weinman J, Hankins M. The beliefs about medicines questionnaire: The development and evaluation of a new method for assessing the cognitive representation of medication. Psychol Health. 1999;14(1):1–24.
- Moss-Morris R, Weinman J, Petrie K, Horne R, Cameron L, Buick D. The Revised Illness Perception Questionnaire (IPQ-R). Psychol Health. 2002;17(1):1–16.
- Vermeire E, Hearnshaw H, Van Royen P, Denekens J. Patient adherence to treatment: three decades of research. A comprehensive review. J Clin Pharm Ther. 2001;26(5):331–42.
- Boyé F, Sallerin B, Ah Kang F, et al. Place du pharmacien clinicien dans la prise en charge thérapeutique du patient hypertendu [Place of clinical pharmacist in the management of drugs in patients with hypertension]. Ann Cardiol Angeiol (Paris). 2015;64(3):216-21.
- Hedegaard U, Kjeldsen LJ, Pottegård A, et al. Improving Medication Adherence in Patients with Hypertension: A Randomized Trial. Am J Med. 2015;128(12):1351-61.
- Cheema E, Sutcliffe P, Weickert MO, Singer DRJ. A randomized controlled trial of the impact of structured written and verbal advice by community pharmacists on improving hypertension education and control in patients with high blood pressure. Eur J Clin Pharmacol. 2018;74(11):1391-5.
Evaluation of pharmacist contribution to adherence and illness perception in hypertension: An observational study
Abstract
Aim: Hypertension (HT) is a chronic disease characterized by high blood pressure and can cause many complications. Pharmacists can contribute to the quality of life and treatment success of HT patients by providing pharmaceutical care service. The aim of our study is to examine the effects of pharmaceutical care services provided by pharmacists on HT illness perceptions and treatment adherence.
Methods: This study was a non-invasive, prospective, observational study with the participation of HT patients who applied to a community pharmacy in Istanbul between June and December 2020. In the first interview, demographic data, illness perceptions, and adherence levels of the participants were measured. At the end of the first interview, the participants were given structured written and oral patient education by the pharmacist, and the effects of the education provided by the pharmacist were measured again in the second interview 90 days later. The Illness Perception Questionnaire and the Morisky Green Levine Treatment Adherence Scale were used to examine the effects of the services provided by the pharmacist after two interviews conducted three months apart.
Results: Of the 75 patients included in our study, 48 (64%) were female, and the mean age was 59.68 ± 10.79 years. 55 participants (73.32%) had a secondary school education or less, and 58 (77.33%) were not working. In our sample, where the mean duration of HT was 11.48 ± 7.24 years, the most frequently prescribed antihypertensive drug group was diuretics. After the pharmaceutical care service provided by the pharmacist, a statistically significant difference was observed in all sub-dimensions of the participants’ illness perception (p<0.05). The adherence level of the participants increased from 79.75% to 90.75% after the pharmacist intervention, and this increase was statistically significant (p<0.05).
Conclusion: It is available in the literature that increased illness perception and adherence in HT patients have positive effects on treatment success and quality of life. In our study, pharmaceutical care service provided by the pharmacist increased the illnes perception and adherence levels. As a result, clinical pharmacists are needed to improve patient care.
Project Number
Yok
References
- World Health Organization (WHO). Cardiovascular diseases (CVDs). Key facts; 2019. Access date June 25, 2023. Available from: https://www.who.int/newsroom/factsheets/detail/cardiovascular-diseases.
- Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. J Am Coll Cardiol. 2018;71(19):e127–e248.
- Mills KT, Bundy JD, Kelly TN, et al. Global disparities of hypertension prevalence and control: a systematic analysis of population-based studies from 90 countries. Circulation. 2016;134:441–50.
- Unger T, Borghi C, Charchar F, et al. 2020 International Society of Hypertension global hypertension practice guidelines. Hypertension. 2020;75(6):1334–57.
- Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). Eur Heart J. 2018;39(33):3021–04.
- Rahayu SA, Widianto S, Defi IR, Abdulah R. Role of Pharmacists in the Interprofessional Care Team for Patients with Chronic Diseases. J Multidiscip Healthc. 2021;14:1701–10.
- Lama S, Souraya D, Youssef F. Statin prescription strategies and atherogenic cholesterol goals attainment in Lebanese coronary artery disease patients. Int J Clin Pharm. 2017;39:919–26.
- Drug Store News. Rx impact: a drug store news special report; 2016: 23. Accessed January 25, 2023. Available from: https://www.nacds.org/pdfs/DSN_RxIMPACT2016.pdf.
- Tsuyuki RT, Al Hamarneh YN, Jones CA, Hemmelgarn BR. The effectiveness of pharmacist interventions on cardiovascular risk: the multicenter randomized controlled RxEACH trial. J Am Coll Cardiol. 2016;67:2846–54.
- Cheema E, Sutcliffe P, Singer DRJ. The impact of interventions by pharmacists in community pharmacies on control of hypertension: a systematic review and metaanalysis of randomized controlled trials. Br J Clin Pharmacol. 2014;78:1238–47.
- Baah-Nyarkoh E, Alhassan Y, Dwomoh AK, Kretchy IA. Medicated-related burden and adherence in patients with co-morbid type 2 diabetes mellitus and hypertension. Heliyon. 2023;9(4):e15448.
- Marfo AFA, Owusu-Daaku FT. Exploring the role of pharmacists in improving blood pressure control among hypertensive patients at the workplace. Sci Afr. 2021;14:e00983.
- Wagner TD, Jones MC, Salgado TM, Dixon DL. Pharmacist’s role in hypertension management: a review of key randomized controlled trials. J Hum Hypertens. 2020;34(7):487–94.
- Di Palo KE, Kish T. The role of the pharmacist in hypertension management. Curr Opin Cardiol. 2018;33(4):382–7.
- Omboni S, Sala E. The pharmacist and the management of arterial hypertension: the role of blood pressure monitoring and telemonitoring. Expert Rev Cardiovasc Ther. 2015;13(2):209–21.
- Vo TH, Charpiat B, Catoire C, et al. Tools for assessing the potential significance of pharmacist interventions: a systematic review. Drug Saf. 2016;39:131–46.
- Whelton PK, Einhorn PT, Muntner P, et al. Research needs to improve hypertension treatment and control in African Americans. Hypertension. 2016;68:1066–72.
- Kara E, Kelleci Çakır B, Sancar M, Demirkan K. Impact of Clinical Pharmacist-led Interventions in Turkey. Turk J Pharm Sci. 2021;18(4):517-26.
- Al-Taie A, Izzettin FV, Sancar M, Köseoğlu A. Impact of clinical pharmacy recommendations and patient counselling program among patients with diabetes and cancer in outpatient oncology setting. Eur J Cancer Care (Engl). 2020;29(5):e13261
- Armay Z, Özkan M, Kocaman N, Özkan S. “Hastalık Algısı Ölçeğinin Türkçe uyarlamasının geçerlilik ve güvenilirlik çalışması.” Adli Psikiyatr. Derg., 2017;8: 271–80.
- Morisky DE, Green LW, Levine DM. Concurrent and Predictive Validity of a Self-Reported Measure of Medication Adherence and Long-Term Predictive Validity of Blood Pressure Control. Med Care 1986;24(1):67-74.
- Patel RP, Taylor SD. Factors affecting medication adherence in hypertensive patients. Ann Pharmacother. 2002;36(1):40-5.
- Aguiar PM, Balisa-Rocha BJ, Brito Gde C, da Silva WB, Machado M, Lyra DP Jr. Pharmaceutical care in hypertensive patients: a systematic literature review. Res Social Adm Pharm. 2012;8(5):383-96.
- Boyé F, Sallerin B, Ah Kang F, et al. Place du pharmacien clinicien dans la prise en charge thérapeutique du patient hypertendu [Place of clinical pharmacist in the management of drugs in patients with hypertension]. Ann Cardiol Angeiol (Paris). 2015;64(3):216-21.
- Hedegaard U, Kjeldsen LJ, Pottegård A, et al. Improving Medication Adherence in Patients with Hypertension: A Randomized Trial. Am J Med. 2015;128(12):1351-61.
- Cheema E, Sutcliffe P, Weickert MO, Singer DRJ. A randomised controlled trial of the impact of structured written and verbal advice by community pharmacists on improving hypertension education and control in patients with high blood pressure. Eur J Clin Pharmacol. 2018;74(11):1391-5.
- McKenney JM, Slining JM, Henderson HR, Devins D, Barr M. The effect of clinical pharmacy services on patients with essential hypertension. Circulation. 1973;48(5):1104–11.
- Mehos BM, Saseen JJ, MacLaughlin EJ. Effect of pharmacist intervention and initiation of home blood pressure monitoring in patients with uncontrolled hypertension. Pharmacotherapy. 2000;20(11):1384–9.
- Ni Y, Chen Y. The effect of pharmaceutical care programs on blood pressure control in individuals with hypertension: a meta-analysis. J Pharm Technol. 2009;25(5):292–6
- Magadza C, Radloff SE, Srinivas SC. The effect of an educational intervention on patients’ knowledge about hypertension, beliefs about medicines, and adherence. Res Social Adm Pharm. 2009;5(4):363–75.
- Peters KF, Horne R, Kong F, Francomano CA, Biesecker BB. Living with Marfan syndrome II. Medication adherence and physical activity modification. Clin Genet. 2001;60(4):283–92.
- Viswanathan H, Anderson R, Thomas J. Evaluation of an antiretroviral medication attitude scale and relationships between medication attitudes and medication nonadherence. AIDS Patient Care STDS. 2005;19(5):306–16..
- Chabot I, Moisan J, Grégoire J-P, Milot A. Pharmacist intervention program for control of hypertension. Ann Pharmacother. 2003;37(9):1186–93.
- Saleem F, Hassali MA, Shafie AA, et al. Pharmacist intervention in improving hypertension-related knowledge, treatment medication adherence and health-related quality of life: a non-clinical randomized controlled trial. Health Expect. 2015;18(5):1270–81.
- Ross S, Walker A, MacLeod MJ. Patient compliance in hypertension: role of illness perceptions and treatment beliefs. J Hum Hypertens. 2004;18(9):607–13.
- Horne R, Weinman J, Hankins M. The beliefs about medicines questionnaire: The development and evaluation of a new method for assessing the cognitive representation of medication. Psychol Health. 1999;14(1):1–24.
- Moss-Morris R, Weinman J, Petrie K, Horne R, Cameron L, Buick D. The Revised Illness Perception Questionnaire (IPQ-R). Psychol Health. 2002;17(1):1–16.
- Vermeire E, Hearnshaw H, Van Royen P, Denekens J. Patient adherence to treatment: three decades of research. A comprehensive review. J Clin Pharm Ther. 2001;26(5):331–42.
- Boyé F, Sallerin B, Ah Kang F, et al. Place du pharmacien clinicien dans la prise en charge thérapeutique du patient hypertendu [Place of clinical pharmacist in the management of drugs in patients with hypertension]. Ann Cardiol Angeiol (Paris). 2015;64(3):216-21.
- Hedegaard U, Kjeldsen LJ, Pottegård A, et al. Improving Medication Adherence in Patients with Hypertension: A Randomized Trial. Am J Med. 2015;128(12):1351-61.
- Cheema E, Sutcliffe P, Weickert MO, Singer DRJ. A randomized controlled trial of the impact of structured written and verbal advice by community pharmacists on improving hypertension education and control in patients with high blood pressure. Eur J Clin Pharmacol. 2018;74(11):1391-5.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Pharmacy and Pharmacy Practice |
| Journal Section | ORIGINAL ARTICLE |
| Authors | |
| Project Number | Yok |
| Publication Date | September 28, 2023 |
| Acceptance Date | September 3, 2023 |
| Published in Issue | Year 2023 Volume: 28 Issue: 3 |
This Journal licensed under a CC BY-NC (Creative Commons Attribution-NonCommercial 4.0) International License.