News

Jan 12, 2018

Learning to Manage Hypertension through a Community-Based Pharmacy Program

By: Ryan Lindenau, PharmD, Middleport Family Health Center

High blood pressure or hypertension (HTN) is a major risk factor for heart disease and stroke. Self-measured blood pressure (SMBP) monitoring is one strategy that can be implemented in communities to reduce the risk of death and complication due to high blood pressure. The Population Health Collaborative received funding from New York State Department of Health to increase engagement of community pharmacists in the provision of medication-/self-management for adults with high blood pressure in WNY.

 

CHALLENGE

Hypertension affects nearly one-third of American adults aged 19 and older (67 million people). HTN is uncontrolled in more than half of adults with the condition and only 61% of adults with uncontrolled HTN are aware they have HTN. According to the NYS e BRFSS, 31.6% of adults in WNY have been diagnosed with HTN. The age-adjusted ER rate per 100,000 due to HTN is 21 in the WNY region. Uncontrolled HTN is associated with increased cardiovascular morbidity and mortality and an increase in healthcare costs. Self-monitoring of blood pressure helps in promoting patient activation and empowerment. It provides individuals the opportunity to monitor their blood pressure on a regular basis and facilitates self-promoted healthy behaviors that ultimately affect blood pressure.

 

SOLUTION

Middleport Family Pharmacy is piloting the distribution of blood pressure cuffs to patients diagnosed with HTN. The pharmacy implemented a medication synchronization program (Med Sync) in their facility to promote SMBP. This effort streamlines a patient’s medication refills, allowing multiple medications to be refilled at the same time each month. It also provides an opportunity for resident pharmacists to follow-up with patients regarding their blood-pressure readings from the past month and provides education to assist patients in blood pressure control. With the support of Local IMPACT funds, the team is developing a toolkit to assist other local pharmacies to implement a similar program.

 

RESULTS Self-Management

39 BP cuffs have been distributed to patients with uncontrolled HTN. 62% of patients have provided BP logs, demonstrating patient activation. Since beginning this program, the average adherence ratio (Medication Possession Ratio) at Middleport Family Health Center (MFHC) is 86%, compared to the national average ratio of 51%. Through this program, 75% of MFHC patients have their blood pressure under control, compared to the national average of 54%. A participant who is pregnant and in the Med Sync program had great results from consistently monitoring her blood pressure. Having been prescribed the maximum dosage of medications for HTN due to her pregnancy, there were few options available for next steps. In working to self-monitor, her blood pressure readings have become more stable over the duration of her engagement with the program.

 

YOUR INVOLVEMENT IS KEY

By involving other community pharmacies across New York State, we can help many more patients achieve their blood pressure goals and ultimately improve health outcomes, while reducing health care expenditures. Pharmacists at Middleport Family Pharmacy are developing a toolkit to help other community-based pharmacies start a similar program. Contact the Population Health Collaborative (info@phcwny.org) to request a kit, expected to be available in Spring 2018.

 

SUSTAINING SUCCESS 

  • This program seeks to: Increase opportunities for patients to monitor their blood pressure at home 
  • Promote patient activation, providing an opportunity for patients to take responsibility for their own health care. 
  • Provide a toolkit to other local pharmacies to assist them in implementing their own program

Follow-up will continue with patients who have already received blood pressure cuffs. Middleport Family Pharmacy will continue to identify new patients with HTN that can be enrolled in the Med Sync and SMBP programs. It is our hope that patients currently involved in the program will continue to be actively engaged in improving their HTN both now and beyond the program.

 

CONTACT

Ryan Lindenau, PharmD

Middleport Family Health Center

81 Rochester Rd

Middleport, NY 14105

716-735-3261 | www.middleportfamilyhealth.com

 

 

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