Effectiveness of a nationwide community pharmacist-led program promoting home blood pressure monitoring on hypertension control and self-management.
Yung-Te Chen, Wan-Yu Yeh, Yi-Chun Hu, Shu-Mei Yang, Ren-Hao Pan, Tzu Han Chen, Yu-Fen Liu, Chien-Yuan Wu, Yann-Yuh Jou, Shi-Lun Wei, Chao-Chun Wu, Hao-Min Cheng
Abstract
Open AccessHome blood pressure (BP) monitoring (HBPM) is fundamental to effective hypertension management. Incorporating community pharmacists into care delivery, especially via hybrid case management methods utilizing digital telemonitoring, presents a promising strategy for enhancing BP control and patient self-management. Nonetheless, the efficacy of these interventions at a national level remains inadequately investigated. We performed a nationwide observational study in Taiwan from September to December 2023. A total of 1216 adults with or at increased risk of hypertension were recruited via community pharmacies. Participants were assigned to either digital case management with telemonitoring or traditional pharmacist-led support for 3 months. Outcomes encompassed alterations in BP, alongside hypertension-related knowledge, attitudes, and self-management behaviors. In hypertensive participants, systolic and diastolic BP decreased from 133.2 ± 12.3 mmHg to 129.8 ± 19.3 mmHg (P = 0.002) 83.1 ± 19.2 mmHg to 79.7 ± 9.0 mmHg (P < 0.001) over a period of 3 months, respectively. The questionnaire achieved a response rate of 94%, with notable enhancements observed in knowledge (+1.2 points), attitude (+4.2 points), and behavior (+3.5 points) scores (all P < 0.001). Older adults, individuals with diminished educational qualifications, and residents of less urbanized regions exhibited more significant improvements. No notable differences were detected between digital and non-digital case management in BP or behavioral outcomes. A nationwide hybrid intervention promoting HBPM via community pharmacist-led case management resulted in substantial enhancements in BP control and self-management outcomes. Moreover, the method was especially advantageous for socially disadvantaged groups. These findings endorse incorporating pharmacist-led hybrid care models into national hypertension management strategies.