Project ImPACT: Hypertension
Participants enrolled in the pharmacy hypertension service met with the pharmacist or student pharmacist 4 times over a 6 month period at the University Pharmacy. Prior to the first visit participants completed a medical intake form and a knowledge survey. Patients received a home blood pressure monitor that was capable of wirelessly transmitting readings to the pharmacy. The first visit was 45-60 minutes and subsequent visits were 15-30 minutes each.
The majority of time during each visit was dedicated to:
- education and coaching about blood pressure, lifestyle modifications, andadherence;
- goal setting; and
- clinical assessment of the patient’s progress.
This data was recorded on a visit encounter form with any medication-related concerns identified by the pharmacist or student pharmacist, how they were addressed in the therapeutic plan, and the status of their resolution. Written letters were used to communicate directly with physicians. Patient education materials compiled by the American Heart Association and the National Institutes of Health were also provided to all participants.
At the end of the 6 months or after 4 visits, participants completed another knowledge and health satisfaction survey with additional questions regarding their perception of pharmacy services.
In addition to regularly using their home blood pressure monitors, patients were instructed to keep a diary about activities that may have impacted any out-of-range blood pressure readings.At each visit, the patient brought in the blood pressure devices and the pharmacist uploaded the data onto the pharmacy computer. A software program created a graph marked with color indicators to visually represent the patient’s readings in relation to goal. The color indicators were the same as those reported by the blood pressure monitored when used at home. The pharmacist used the green (at goal), yellow (borderline), orange (stage I hypertension), and red (stage II hypertension) indicators as a springboard for discussion with the patient about causes of blood pressure variability. Through these targeted conversations about the home readings and diary entries, the pharmacist was able to identify patterns and hypertensive triggers.