High blood pressure causes major health problems for many people around the world and work goes on all the time to improve the monitoring and control of blood pressure in patients who have the condition. A new study has shown that pharmacists may be very good at keeping an eye on the BP levels in groups of selected patients. A new bit of internet software and a secure Web interface helped control BP in a group of about three thousand American patients.
Those with high BP are at risk of stroke or heart attack if the problem is not brought under better control. Both stroke and heart attack can lead to either early death or a severe deterioration in the quality of life. Smoking, diabetes and a high cholesterol level are also commonly found in those people with high BP and the combination of these factors is extremely dangerous if not dealt with properly.
Many people with hypertension / high BP need to take medication on a daily basis. Sometimes just one tablet a day is enough but in many cases it needs a combination of BP tablets and some medication to lower the cholesterol level too. All of this can result in side effects due to the interactions of the BP drugs with each other and with any other medication that the patient is taking. Almost all of those who take regular blood pressure medications will experience drug related side effects of one sort or another. Common side effects are fatigue, cough and – in men – problems with a loss of sex drive and a loss of sexual arousal due to the BP meds.
Hypertension (the other name for high blood pressure) is often poorly controlled and BP levels often run high even in those who are on medication every day. Research done previously has shown benefit by adding input from a nurse or pharmacist into the patients care pathway.
The research used a home BP monitor with the results supervised by a pharmacist – the patients fed their results into a secure web based form and the pharmacist reviewed the readings and worked closely with each patient. The group studied were all adults between 25 and 75 – all had poorly controlled hypertension but were otherwise well.
The patients were divided randomly into three groups: group one had their usual care; group two had home BP monitoring and secure patient Web services training only but no pharmacist input and group three had the full package of home BP monitoring and Web training plus pharmacist care management delivered through Web communications.
The results showed that there was no real difference in BP readings in the two groups who did not have a pharmacist looking after them – both groups saw no real change in their BP control. But the group with the pharmacy input saw much better results. Fifty percent of the patients developed readings that were normal when they had previously been high all the time.
It looks like Web-based pharmacy care of people with hypertension is feasible and can improve BP control and I suspect we may see a lot more of this kind of thing in the future.
Dr Gordon Cameron is a blood pressure specialist based in Scotland. You can read much more about how to lower blood pressure at his website. He has also written extensively about the issues that arise with a blood pressure too low