Assessing Medication Consultations, Hypertension Control, Awareness, and Treatment Among Elderly Asian Community Dwellers Research and Reports

Objective: To describe blood pressure (BP) and medication-related findings of a pharmacist-conducted hypertension (HTN) monitoring program.

Study design: Retrospective post hoc analysis.

Setting: Community site.

Patients: Multiethnic, community-dwelling, Asian older adults.

Interventions: Medication consultation/BP records from 1998-2005 were reviewed. Participants' mean baseline BP readings were classified using guidelines from the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7) and stratified into three groups: ≤ 70, 71-79, and ≥ 80 years of age. Medication consultations were grouped into: lifestyle/general medication review, adherence assessment, non-HTN medication consults, and specific consults, which included pharmacist-provided, medication-related recommendations. Participants with specific consults and subsequent self-reported changes in HTN therapy were identified. Their mean BP readings at six months, before and after the self-reported changes, were assessed for differences, using paired t-test, P ≤ 0.05 was significant.

Main Outcome Measures: Baseline HTN treatment/awareness rates, age-stratified HTN control, number/types of HTN medications used, adherence problems, consultations provided, BP changes in participants who self-reported changes in medication therapy.

Results: Among 414 participants (averaged 74.2 ± 8.5 years of age, 34.1% male), baseline HTN rate, awareness rate, and treatment rates were 51.9%, 37.9%, and 24.9%, respectively. Baseline BP worsened with increasing age. Overall, 258 participants received 651 consultations. The most prevalent nonadherent behavior reported was selfadjustment of medication dosing. Among 65 participants who received HTN medication-related advice, 52/65 (80%) reported changes in medication therapy and showed significant improvement in BP at six months before and after the self-report.

Conclusion: HTN awareness/treatment rates were low in the entire population. HTN control was worst among the oldest individuals. Implementing initiation or adjustments in medication therapy can potentially improve BP control.

Abbreviations: BP = Blood pressure, BRFSS = Behavioral Risk Factor Surveillance System, CDC = Centers for Disease Control and Prevention, DBP = Diastolic blood pressure, HTN = Hypertension, JNC = Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, NHANES = National Health and Nutrition Examination Survey, OTC = Over-the-counter, SBP = Systolic blood pressure. Consult Pharm 2008;23:795-803.