Experience, Barriers, Supports, and Outcomes of Pharmaceutical Care in Hypertensive Patients by Pharmacists in Primary Care Cluster, Health Region 6

Abstract

The sequential embedded mixed-method research consisted of two phases. In phase 1, the qualitative phase was aimed to explore the experience, barriers and supports of the pharmacists in the primary care cluster. Focus group discussion was conducted with 24 pharmacists from 6 provinces of the health region 6. Findings of content analysis comprised three main themes: barriers and supports from the policy; colleagues; and the pharmacist. The barrier was the health information access and incomplete data flows from the primary care cluster to the hospital and vice versa. Effective patient care needed inter-professional teamwork in receiving updated medication knowledge from the part-time pharmacist in the primary care unit. Communication skills helped the pharmacist provide effective resolutions to drug-related problems (DRPs). In phase 2, the prospective, quasi-experimental study aimed to examine DRPs, blood pressure control, and physician acceptance to pharmacists’ roles, as well as, to examine relationships of patient’s or pharmacist’s factors with the effective resolutions to DRPs. Data collection form of DRPs was adopted from Cipolle et al’s classification. Quantitative data collection was performed on 1,471 hypertensive patients who were attended consecutively 3 visits by the pharmacists participated in the phase 1. Of all 379 DRPs identified, the highest problem was 164 of non-adherence (43.3%). After the primary pharmacy care, the DRPs were significantly decreased by 33.2% and 32.4% ((2)=46.78, p < 0.001) at visit 1 and 2, respectively. Blood pressure was unchanged. Physician acceptance rates to pharmacists’ roles were 77.8%, 70.3% and 68.4% consecutively. The factor related to the effective resolving non-adherence was the physician acceptance (rs = 0.18, p = 0.020), consistent to phase 1’s findings. This sequential embedded mixed-method research provided linkages of all findings which clearly illustrated the overview duty of primary care pharmacy.