Blood pressure control in hypertensive patients: impact of an Egyptian pharmaceutical care model

Hypertension is poorly managed in Egypt due to low rates of awareness about the disease. The aim of this study was to describe the role of the pharmacist as a health care provider and the implementation of a pharmaceutical care model to improve medications adherence, BP control, knowledge and quality of life (QOL) in a sample of Egyptian patients suffering from hypertension. A total of 280 hypertensive adults, whether their BP was controlled or not, were enrolled in the study and randomly classified into either control group (CG) or intervention group (IG); both received the usual hospital care and kept on their antihypertensive. Patients in the IG, beside the usual hospital care, received a pharmaceutical care program described in the methods. All patients visited the clinic monthly up to three months for check and evaluation. Significant improvements were observed in the studied parameters for the IG compared with the CG, at the end of the study, although there was no significant difference (P > 0.05) between them in demographics and characteristics at the baseline. At the end of the study, a significant lower SBP (-8.2 mmHg, P = 0.003) and DBP (-5.4 mmHg, P = 0.001) levels were observed in the IG with significantly higher BP control (P=0.018). Also, medication adherence was significantly higher (P = 0.002) in the IG (27.2%, 52.8%, 20.0% vs 48.6%, 33.6%, 17.8% for low, intermediate and high adherence, respectively). Similarly, patients’ knowledge, attitude and practice were significantly improved (P = 0.001) in IG ((20.5+1.8), (4.7+1.0), (4.7+1.0), respectively) vs ((13.7+7.2), (3.8+1.8), (2.9+2.0), respectively) for the CG. While end of study QOL for the IG, increased significantly compared with the CG (P = 0.001, 0.001, 0.020, 0.010 and 0.016 for patients’ rate of QOL, enjoy, energy, sleep and access to health system, respectively), most of QOL dimensions were decreased significantly from their baseline in the CG. Conclusion: Pharmacist intervention can significantly improve BP control, medication adherence, patients’ knowledge, attitude, practice and QOL in hypertensive Egyptian patients treated with antihypertensive agents.