Managing Medication Adherence in Elderly Hypertensive Patients Through Pharmacist Home Visits.

OBJECTIVE

The purpose of the Managing Your Blood Pressure program was to reduce health disparities in blood pressure (BP) control by improving medication adherence in a cohort of geriatric African-Americans with hypertension (HTN).

DESIGN

The program was implemented using a quasi-experimental pre- and postintervention study design that utilized a pharmacist home-based model and follow-up educational phone calls to impact BP over a six-month period.

SETTING

Home visits occurred in participants' residences, and phone calls occurred at program headquarters at Texas Southern University (Houston, Texas).

MAIN OUTCOME MEASURES: The primary outcome measure was BP control rate, and secondary outcome measures were knowledge of HTN, medication adherence, and use of a BP monitor.

RESULTS

At six months, 306 of the 431 patients recruited completed all phases of the program (two in-home consultations and biweekly telephone consultations). At the end of the six-month intervention period, the reduction in mean systolic BP was statistically significant (baseline 140 mmHg vs. six months 137 mmHg; P < 0.049). No difference in mean diastolic BP pre- and postintervention was found. The percent of patients with controlled BP improved from 46.7% to 49.5%; P = 0.34. Medication adherence, self-monitoring of BP, and knowledge of HTN were significantly improved from baseline to postintervention.

CONCLUSION

Pharmacist-led interventions in the home were effective in improving BP control and medication adherence. Further programs are needed to address uncontrolled HTN in this vulnerable population.