Targeting hypertension by helping pharmacists deliver enhanced patient care

September 19, 2015, University of Alberta Faculty of Medicine & Dentistry
Ross Tsuyuki, Bernie Frost, and Lonni Johnson. Credit: Faculty of Medicine & Dentistry, University of Alberta

Patients with high blood pressure are benefiting from the expanded role played by pharmacists in Alberta, according to a new study from the University of Alberta's Faculty of Medicine & Dentistry.

The results of the Rural Alberta Clinical Trial in Optimizing Hypertension (RxACTION) were published in the July edition of the journal Circulation. In the study, researchers compared conventional treatment of hypertension to "enhanced" pharmacist care—in which pharmacists independently prescribe antihypertensive drugs and take a more active role in managing patients. They found that at six months, the enhanced care resulted in significantly larger reductions in both systolic and diastolic blood pressure compared with usual care.

Patients who received the enhanced care were also twice as likely to reach their recommended blood-pressure targets as those treated conventionally.

"In Canada about 25 per cent of the population has and about two-thirds of it is controlled. But that means that about one-third is uncontrolled," says Ross Tsuyuki, lead author of the study, professor of medicine at the Faculty of Medicine & Dentistry, and a member of Alberta Health Services Cardiovascular Health & Stroke Strategic Clinical Network. "With a condition like high blood pressure, the treatment is virtually all about drugs—which is a field of medicine that pharmacists excel in. This work shows there is a real opportunity to better utilize pharmacists in our health-care system."

Alberta is the first jurisdiction in Canada and only the second in the world where pharmacists can apply to prescribe medications independently for patients.

The RxACTION project included 248 patients from 23 communities—most of them in rural Alberta. Two-thirds of the patients received care from prescribing pharmacists, with the remaining patients getting the usual care. The intervention group's care consisted of pharmacist assessment of the patients' risks, a review of their medications and the prescribing of new drug therapy if necessary. The patients also had regular follow-up from their pharmacists over the course of six months.

Lonni Johnson, a pharmacist at Winter's Pharmacy South in Drayton Valley who participated in the study, says her patients have benefited.

"They absolutely love the care they are getting," says Johnson. "They are gaining control over their high , they know what they're taking and why they're taking it, and they have a better understanding of what they can do in their lifestyle to make things better."

Bernie Frost, a patient of Johnson's, agreed to take part in the RxACTION study three years ago. He says he wouldn't go back to the care he received before.

"I get one-on-one attention and a lot more information now about the medications I'm on. Going to the doctor before, it could take a week and a half sometimes to get in to see him. So if I can drop in to the pharmacist instead to renew my prescription, it saves a lot of time."

Frost adds, "I'm not sure if my health has improved but my knowledge is definitely better."

With the success of RxACTION, Tsuyuki's team is now working to implement the higher level of care in pharmacies across the province. It is also in the midst of a larger study called RxEACH with Alberta Health Services and Alberta Health aimed at identifying Albertans at risk for vascular disease, then providing them with screening and management strategies through a intervention.

Johnson, who is participating in the new study, says she is excited to play a greater role in managing her ' health in the future.

"I think this is the way we need to go in pharmacy. It's amazing! I do not want to practise as I have in the past. I want to move forward and change, and to play an even greater role within our patient's health-care team."

Explore further: Pharmacists play key role in improving patient health

Related Stories

Pharmacists play key role in improving patient health

June 15, 2015
Over the past nine years, Scot H. Simpson, professor in the faculty of Pharmacy and Pharmaceutical Sciences at the University of Alberta, has been studying the role of pharmacists on primary care teams and their impact on ...

Studies find pharmacists help patients control blood pressure

May 15, 2015
If you have hypertension, it pays to include a pharmacist in a medical-care team.

Pharmacists help patients with hypertension

July 30, 2015
If you have hypertension, it pays to include a pharmacist in a medical care team.

Pharmacists can significantly improve blood pressure, cholesterol in stroke patients

April 14, 2014
Stroke patients managed by a pharmacist had a 12.5% improvement in blood pressure and low-density lipoprotein (LDL), or "bad" cholesterol levels compared with a control group, according to a clinical trial published in CMAJ ...

Research suggests team-based care is most effective way to control hypertension

October 22, 2014
Patients diagnosed with high blood pressure are given better control of their condition from a physician-pharmacist collaborative intervention than physician management alone, according to new research.

Recommended for you

Caffeine from four cups of coffee protects the heart with the help of mitochondria

June 21, 2018
Caffeine consumption has been associated with lower risks for multiple diseases, including type II diabetes, heart disease, and stroke, but the mechanism underlying these protective effects has been unclear. A new study now ...

New cellular pathway helps explain how inflammation leads to artery disease

June 21, 2018
Investigators have identified a new cellular pathway that may help explain how arterial inflammation develops into atherosclerosis—deposits of cholesterol, fats and other substances that create plaque, clog arteries and ...

'Smart stent' detects narrowing of arteries

June 19, 2018
For every three individuals who have had a stent implanted to keep clogged arteries open and prevent a heart attack, at least one will experience restenosis—the renewed narrowing of the artery due to plaque buildup or scarring—which ...

Marriage may protect against heart disease / stroke and associated risk of death

June 18, 2018
Marriage may protect against the development of heart disease/stroke as well as influencing who is more likely to die of it, suggests a pooled analysis of the available data, published online in the journal Heart.

Deaths from cardiac arrest are misclassified, overestimated

June 18, 2018
Forty percent of deaths attributed to cardiac arrest are not sudden or unexpected, and nearly half of the remainder are not arrhythmic—the only situation in which CPR and defibrillators are effective—according to an analysis ...

Tick-borne meat sensitivity linked to heart disease

June 15, 2018
University of Virginia School of Medicine researchers have linked sensitivity to an allergen in red meat—a sensitivity spread by tick bites—with a buildup of fatty plaque in the arteries of the heart. This buildup may ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.