Home Providing counseling through home pharmacy care (HPC) for hemodialysis patients with hypertension in lowering blood pressure
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Providing counseling through home pharmacy care (HPC) for hemodialysis patients with hypertension in lowering blood pressure

  • Rahmiyati Daud , Bambang Subakti Zulkarnain EMAIL logo and Ivan Virnanda Amu
Published/Copyright: June 25, 2021

Abstract

Objectives

Hypertension is one of the main factors in increasing the risk of cardiovascular disease with 51% reported cause of death in chronic kidney disease (CKD) patients with end-stage renal disease (ESRD). It is a comorbid that needs to be managed properly and gets special attention from various health disciplines including a pharmacist.

Methods

This was a quasi experimental study with pretest–posttest intervention using home pharmacy care (HPC) counseling both on the counseling and the noncounseling group. Initial data collection and informed consent was done at the Hemodialysis Unit Aloei Saboe and Toto Kabila Hospital, Gorontalo. The parameters in the study were patients’ compliance to their medication using the Medication Adherence Questionnaire (MAQ) and Pill Count Adherence (PCA) questionnaires and the patient’s blood pressure.

Results

Fifty-eight patients met the inclusion criteria and were divided into two groups (the counseling group and the noncounseling group). Based on MAQ and PCA, the level of patient medication adherence increased significantly in the counseling group compared to the noncounseling group with a significance value of p<0.05. Increasing adherence was correlated with patients’ outcome of lowering blood pressure. More patients in the counseling group showed decrease in systolic and diastolic blood pressure compared to the noncounseling group (86.2 vs. 17.2% for systolic BP and 69 vs. 10.3% for diastolic blood pressure (BP). Following adjusted confounding variables, counseling through HPC provided a chance of decreasing systolic blood pressure 32 times (95% CI: 7.198–144.550) and diastolic blood pressure 42 times (95% CI: 6.204–286.677).

Conclusions

HPC affects the improvement of patient medication adherence and reduction of blood pressure in hemodialysis patients with hypertension.


Corresponding author: Bambang Subakti Zulkarnain, Department of Clinical Pharmacy, Faculty of Pharmacy, Airlangga University, Surabaya, Indonesia, Phone: +62 811 3419355, E-mail:

Acknowledgments

The researcher expresses her sincere gratitude to hemodialysis patients and their families who volunteered to participate and the nurses in the hemodialysis unit who helped make this study successful. Also, special thank to the Aloei Saboe Hospital and Toto Kabila Hospital for the permission to conduct this study.

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: The local Institutional Review Board deemed the study exempt from review.

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Received: 2020-11-29
Accepted: 2021-03-08
Published Online: 2021-06-25

© 2021 Walter de Gruyter GmbH, Berlin/Boston

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