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Role of clinical pharmacist in the management of blood pressure in dialysis patients

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Abstract

Background Hypertension is highly prevalent yet undertreated condition in hemodialysis patients. Objective The objective of this study was to evaluate clinical pharmacist’s role in the management of blood pressure in hemodialysis patients guided by home blood pressure monitoring. Setting Outpatient hemodialysis units of Jordan University Hospital and Isra’a Hospital. Method This was a randomized controlled study. It lasted 6 months (September 2011 till the end of March 2012). All hypertensive patients receiving hemodialysis were invited to participate in the study. Out of 60 patients approached, 56 were actually included. Patients were randomly allocated to an intervention (29) or control group (27). In the intervention arm, patients received physician-pharmacist collaborative care. While in the control arm patients received standard medical care. Main outcome measure Percentage of patients achieving weekly average home blood pressure below or equal 135/85 mmHg. Other secondary measures that were assessed include absolute reduction in peridialysis blood pressure, interdialytic weight gain, adherence to medications and dialysis sessions. Results A total of 52 patients completed the study. Forty-six percent of patients in the intervention arm achieved BP target (mean home blood pressure ≤135/85 mmHg) compared to only 14.3 % of patients in the control arm (p = 0.02). Average decline in weekly mean home systolic blood pressure was 10.9 ± 17.7 mmHg in the intervention arm (p = 0.004), while weekly mean home systolic blood pressure increased by 3.5 ± 18.4 mmHg in the control arm (p = 0.396). No significant reduction was achieved in weekly home diastolic blood pressure, dialysis blood pressure readings, or interdialytic weight gain in either arm. Conclusions Clinical pharmacist-physicians’ collaboration improved rate of blood pressure control in hemodialysis patients. Using home blood pressure monitoring was found to be an efficient way to guide blood pressure therapy.

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Acknowledgments

Special thanks to hemodialysis patients who participated in the study and committed through and staff nurses in the dialysis unit of Jordan University Hospital and Isra’a Hospital for their assistance and cooperation.

Funding

This study was supported by the Deanship of research, The University of Jordan.

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Authors and Affiliations

  1. Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, University of Jordan, Amman, Jordan

    Bonyan Qudah & Abla Albsoul-Younes

  2. Department of Internal Medicine, Faculty of Medicine, University of Jordan, Amman, Jordan

    Ezat Alawa

  3. Division of Nephrology and Internal Medicine, Isra’a Hospital, Amman, Jordan

    Nabil Mehyar

  4. Hamdi Mango Center for Scientific Research, Amman, Jordan

    Abla Albsoul-Younes

  5. Chair, Pharmaceutical Care Section, University of Jordan Hospital, Amman, Jordan

    Abla Albsoul-Younes

Authors
  1. Bonyan Qudah
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  2. Abla Albsoul-Younes
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  3. Ezat Alawa
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  4. Nabil Mehyar
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Correspondence to Abla Albsoul-Younes.

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Qudah, B., Albsoul-Younes, A., Alawa, E. et al. Role of clinical pharmacist in the management of blood pressure in dialysis patients. Int J Clin Pharm 38, 931–940 (2016). https://doi.org/10.1007/s11096-016-0317-2

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  • DOI: https://doi.org/10.1007/s11096-016-0317-2

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