PMID- 27053077
OWN - NLM
STAT- MEDLINE
DCOM- 20170816
LR  - 20180827
IS  - 1544-3450 (Electronic)
IS  - 1086-5802 (Linking)
VI  - 56
IP  - 3
DP  - 2016 May-Jun
TI  - Medication adherence and activity patterns underlying uncontrolled hypertension: 
      Assessment and recommendations by practicing pharmacists using digital health 
      care.
PG  - 310-5
LID - S1544-3191(16)00117-5 [pii]
LID - 10.1016/j.japh.2016.01.005 [doi]
AB  - OBJECTIVES: This report summarizes the first use of a digital health feedback 
      system (DHFS) by practicing pharmacists to establish evidence-based blood 
      pressure (BP) management recommendations. SETTING: Fifteen commercial pharmacies 
      and 39 patients in the Isle of Wight participated. PRACTICE DESCRIPTION: The 
      pharmacists were experienced in providing New Medicine Services to patients in 
      their communities. PRACTICE INNOVATION: The pharmacists utilized a commercially 
      available DHFS. The DHFS utilized FDA-cleared and CE-marked class 2 medical 
      devices passively captured and shared information about medication-taking using 
      an ingestible sensor, and daily patterns of rest, activity, and exercise using a 
      wearable patch that incorporates an accelerometer. INTERVENTIONS: Pharmacists 
      provided targeted counselling for BP management as guided by the digital 
      information. EVALUATION: Blood pressure was measured serially, and patient and 
      provider experiences with DHFS use were assessed using satisfaction surveys. 
      RESULTS: The mean change in SBP over the 2-week evaluation period was -7.9 +/- 
      22.1; mean change in DBP was -2.8 +/- 12.9. A root cause for persistent 
      hypertension was determined for all of these 34 patients: 68% had pharmaceutical 
      resistance, and 32% had inadequate medication use. Specifically, 29% were found 
      to be capable to achieving blood pressure control on their currently prescribed 
      medications, 68% were found to have a need for additional pharmacological 
      treatment, and 3% needed additional adherence support. Pharmacists found that the 
      DHFD helped in targeting specific recommendations, and to create a collaborative 
      experience with their patients. Patients found the experience to be positive and 
      helpful. CONCLUSION: DHFS that provides confirmation of medication taking and 
      objective measures of lifestyle patterns can help pharmacists to identify 
      specific factors contributing to uncontrolled hypertension, to make 
      evidence-based prescribing and lifestyle recommendations for achieving treatment 
      goals, and to create a collaborative experience for patients in the management of 
      their self-care.
CI  - Copyright (c) 2016 American Pharmacists Association(R). Published by Elsevier Inc. 
      All rights reserved.
FAU - Noble, Kevin
AU  - Noble K
FAU - Brown, Karl
AU  - Brown K
FAU - Medina, Maria
AU  - Medina M
FAU - Alvarez, Francis
AU  - Alvarez F
FAU - Young, Julian
AU  - Young J
FAU - Leadley, Sarah
AU  - Leadley S
FAU - Kim, Yoona
AU  - Kim Y
FAU - DiCarlo, Lorenzo
AU  - DiCarlo L
LA  - eng
PT  - Journal Article
DEP - 20160401
PL  - United States
TA  - J Am Pharm Assoc (2003)
JT  - Journal of the American Pharmacists Association : JAPhA
JID - 101176252
RN  - 0 (Antihypertensive Agents)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antihypertensive Agents/administration & dosage/*therapeutic use
MH  - Blood Pressure
MH  - Female
MH  - Humans
MH  - Hypertension/*drug therapy
MH  - Male
MH  - *Medication Adherence
MH  - Middle Aged
MH  - Pharmacists/*organization & administration
MH  - Remote Sensing Technology/*instrumentation
MH  - Self Care
MH  - State Medicine
MH  - United Kingdom
EDAT- 2016/04/08 06:00
MHDA- 2017/08/17 06:00
CRDT- 2016/04/08 06:00
PHST- 2015/12/15 00:00 [received]
PHST- 2016/01/22 00:00 [revised]
PHST- 2016/01/23 00:00 [accepted]
PHST- 2016/04/08 06:00 [entrez]
PHST- 2016/04/08 06:00 [pubmed]
PHST- 2017/08/17 06:00 [medline]
AID - S1544-3191(16)00117-5 [pii]
AID - 10.1016/j.japh.2016.01.005 [doi]
PST - ppublish
SO  - J Am Pharm Assoc (2003). 2016 May-Jun;56(3):310-5. doi: 
      10.1016/j.japh.2016.01.005. Epub 2016 Apr 1.