The role of clinical pharmacist in the management of resistant hypertension.

Abstract

Background: Hypertension is a major contributor to global cardiovascular morbidity and mortality. Treatment-resistant hypertension (TRH) presents a significant management challenge, requiring a pharmacist-physician collaborative model to achieve sustained blood pressure (BP) control.

Aim: This study aims to evaluate the impact of a clinical pharmacy interventions on BP control, medication adherence, and patient outcomes in patients with TRH in a primary care setting.

Methods: A randomized controlled trial was conducted involving 142 patients with TRH at two primary care clinics. Participants were randomly assigned to either the intervention group, receiving clinical pharmacy services including medication reviews and personalized counseling, or the control group, receiving standard care. Medication adherence was assessed using the Medication Adherence Rating Scale, and patient outcomes, including BP control and quality of life (QoL), were measured over a 6-month period.

Results: The intervention group demonstrated a significant improvement in medication adherence compared to the control group (p < 0.001), with an effect size of - 1.75. Clinical parameters, such as BP (mean reduction in BP: 27.9/13.4 mmHg), showed more favorable outcomes in the intervention group (p = 0.003). Furthermore, patients receiving clinical pharmacy services reported higher QoL scores (p < 0.001) and expressed higher satisfaction with medication management.

Conclusion: Clinical pharmacy interventions significantly enhance medication adherence and improve patient achievement of target BP goals in TRH patients. Incorporating clinical pharmacy services into routine care can lead to better health management and increased patient QoL. Further research is needed to explore long-term benefits and cost-effectiveness.