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.