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首页> 外文期刊>Journal of Clinical Pharmacy and Therapeutics >A multifaceted pharmacist intervention to improve antihypertensive adherence: A cluster-randomized, controlled trial (HAPPy trial)
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A multifaceted pharmacist intervention to improve antihypertensive adherence: A cluster-randomized, controlled trial (HAPPy trial)

机译：改善抗高血压依从性的多方面药剂师干预措施：一项集群随机对照试验（HAPPy试验）

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What is known and objectives About half of all patients taking antihypertensives discontinue treatment by 12 months. There is potential for substantial health gains at both individual and population levels through improved treatment adherence. The objective was to evaluate a community pharmacist intervention to improve adherence with antihypertensive medicines with a view to improving blood pressure (BP) control. Methods Design: prospective, non-blinded, cluster-randomized, controlled trial. Participants: adults with primary hypertension who obtained antihypertensives in the previous 6 months. Patients with poor refill adherence were preferentially identified with the help of a purpose-built software application. Intervention: package comprising BP monitor; training on BP self-monitoring; motivational interviewing; medication use review; prescription refill reminders. Follow-up: six months. Primary outcome: change in proportion self-reporting medication adherence. Secondary outcome: BP changes. Results Participants (n = 395; intervention - 207; control - 188) had a mean age of 66.7 years; 51.1% were males. The proportion of adherent participants increased in both groups but was not significantly different between groups [57?% to 63?% (control) vs. 60?% to 73?% (intervention), P = 0?3]. The mean reduction in systolic BP was significantly greater in the intervention group (10? mmHg vs. 4? mmHg; P = 0?5). The proportion of patients who were non-adherent at baseline and adherent at 6 months was 22?% (95%CI 5?-40?%) higher in the intervention group (61?% vs. 39?%, P = 0?07). Among participants with baseline BP above target, reduction of systolic BP was significantly greater in the intervention group [by 7? mmHg (95%CI 1?-12? mmHg); (P = 0?1)]. Among participants non-adherent at baseline and above target BP, the proportion reporting adherence at 6 months was significantly greater in the intervention group [56?% vs. 35?%, P = 0?39). What is new and conclusion This community pharmacist intervention resulted in improved adherence to antihypertensive medication and reduced systolic BP.
机译：已知和目标服用降压药的所有患者中约有一半在12个月内中断治疗。通过改善治疗依从性，有可能在个人和人口水平上获得实质性的健康改善。目的是评估社区药剂师的干预措施，以改善对降压药的依从性，以改善血压（BP）的控制。方法设计：前瞻性，非盲，聚类随机，对照试验。参与者：原发性高血压的成年人，在过去6个月中获得过降压药。优先使用专用软件应用程序识别笔芯依从性差的患者。干预：包括BP监护仪的包装; BP自我监控培训;动机面试;药物使用审查;处方笔芯提醒。随访：六个月。主要结果：自我报告药物依从性的比例发生变化。次要结果：血压改变。结果参与者（n = 395;干预措施-207;对照组-188）的平均年龄为66.7岁; 51.1％是男性。两组的依从性参与者比例均增加，但两组之间无显着差异[对照组为57％至63％（vs.干预组）为60％至73％（P = 0.3）。干预组的平均收缩压明显降低（10？mmHg vs. 4？mmHg; P = 0？5）。干预组在基线时未坚持治疗并在6个月坚持治疗的患者比例增加了22％（95％CI 5？-40％）（61 %% vs. 39％，P = 0？）。 07）。在基线血压高于目标的参与者中，干预组的收缩压降低明显更大[降低了7？毫米汞柱（95％CI1≤-12≤毫米汞柱）; （P ＝0≤1）]。在基线时未依从且血压高于目标BP的参与者中，干预组在6个月时报告依从性的比例显着更高[56 %% vs. 35 %%，P = 0.39]。新增功能和结论该社区药剂师的干预导致对降压药的依从性提高，收缩压降低。

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