Importance of random blood pressure screenings and general patient knowledge in an ambulatory care setting
Uncontrolled hypertension is one of the largest risk factors and predictors of major cardiovascular events. There are a plethora of ways for the general public to have their blood pressure checked, but many people do not know how to interpret their results. It is thought that 1/3 of adults in the United States has hypertension, and many go undiagnosed. The purpose of this study was for a student pharmacist to interact with patients in an ambulatory care setting to screen for hypertension and to counsel patients on high blood pressure and medications used for management.
A national chain pharmacy gave permission to set up a screening site once a week for 12 weeks and allow blood pressure (BP) measurements with an offer for free individual counseling to those patients. Advertisements were distributed to customers and patients voluntarily sat down to receive counseling. A short questionnaire was developed to test patient’s general knowledge about blood pressure. This was given at the start to help guide the counseling session. After a 1-3 minutes, the patient’s blood pressure was taken and recorded with their questionnaire results as well as a history for BP medications. Educational materials such as home blood pressure technique, DASH diet information and personal blood pressure logs were given to those who requested as well those who had higher readings. Education consisted of counseling on adherence, proper medication administration including new data suggesting that splitting BP medications for twice daily administration can improve BP control. Descriptive statistics were used to analyze the data and to assess the success of patient interactions.
123 patients were screened over the 12 weeks. Patients displayed a good knowledge of sodium intakes relationship to BP (79%) and that people can have hypertension and not know it (97%). They also displayed a good knowledge about not stopping medications once you have been diagnosed with high blood pressure. The data showed that patients did not have a good understanding of what a normal BP should be. 10.5% of patients who did not take BP medications knew a normal BP versus patients who had the diagnosis of hypertension. 43% of the patients who took 1 or 2 medications for BP know the normal range. Whereas, only 30% of patients who take 3 or more medications knew the normal target range for BP. Nine of 46 (19.6%) patients without a diagnosis of hypertension screened with a high systolic and/or diastolic BP. These patients were referred with a written note to their health care provider for a second BP screening and they were encouraged to retest at the pharmacy. All patients on BP medications were offered additional education and counseling.
At the end of 12 weeks, data further confirmed the importance of random blood pressure screenings in an ambulatory care setting and the need for continued emphasis on patient education