Advertisement	October 15, 2014 Pharmacists Armed With Pill Boxes Help Lower Patients’ Blood Pressure Asheville, NC—Pharmacists employing very simple tools—pill boxes—were able to help hypertension patients lower their systolic blood pressure (BP) by 10 mmHG by improving adherence to drug regimens, according to a new study. A year after a hypertension diagnosis, about half of all patients discontinue their medications while only about half of those continuing on their drugs are more than 80% adherent to their regimen, according to researchers from the Charles George Veterans Affairs Medical Center in Asheville, NC. “Two-thirds of Americans who are prescribed antihypertensive medications are not at a blood pressure (BP) goal of < 140/90 mmHg, and low adherence is identified as a primary cause of inadequate control,” according to background information in the report. “Improved adherence to antihypertensive medications has been shown to enhance BP control and reduce the risk of cardiovascular complications. This study investigated the effectiveness of a pill box clinic to improve BP in veterans with uncontrolled hypertension taking three or more antihypertensive medications.” The study, with results reported recently in the Journal of Managed Care & Specialty Pharmacy, enrolled 60 veterans—50 of whom completed two out of three of their appointments and 45 completing all three appointments. Under the supervision of a pharmacist, each patient was provided two 7-day pillboxes to organize all antihypertensive medications. In addition, baseline BP and previous history of nonadherence were documented. Following the initial encounter, patients were asked to attend two follow-up appointments, at 2 and 4 weeks, for refill of pillboxes, BP measurement, and adherence assessment. Results indicate that 24% achieved at least a 10 mmHg reduction in systolic BP from baseline to appointment 2, and 31% reached that goal by appointment 3. By appointments 2 and 3, 44% and 51%, respectively, of patients had reached the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7) goal of less than 140/90 mmHG for patients without diabetes or kidney disease. All patients had adherence rates of more than 80% based on pill counts at the second and third appointments. “Although [overall] results were not statistically significant, the pill box clinic resulted in clinically significant reductions in systolic BP by 10mmHG, as well as an increased number of patients meeting prescribed BP goals,” the authors conclude. “The findings from this pre/post prospective study suggest BP goals are more likely to be met when antihypertensive medications are organized in a pill box, and use of the pill box is monitored by a pharmacist.” Click here for October 15, 2014 USP Weekly News Update.
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