Scottish adherence to antihypertensive medication in the elderly (SAAME) study: promotng evidence-based community pharmacy services.
Stewart, Derek C.
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MACLURE, K., CRAIG, G., POWER, A., PEDDIE, S., OSPREY, A., BOYTER, A., COUSINS, G., MACLURE, A. and STEWART, D. 2017. Scottish adherence to antihypertensive medication in the elderly (SAAME) study: promoting evidence-based community pharmacy services. Presented at the 46th European Society of Clinical Pharmacy symposium (ESCP): clinical pharmacy science meets practice - towards evidence-based clinical pharmacy services, 9-11 October 2017, Heidelberg, Germany.
Background and Objective: Detection and treatment of hypertension continues to be a major public health challenge affecting between 30 and 45% of the general population, increasing steeply with age. Many studies have shown the benefit of antihypertensive agents in improving clinical outcomes. However, their effectiveness is dependent on persistent adherence to prescribed medication. Objectives (1) to assess adherence to antihypertensive medication; (2) to examine patient-specific factors associated with antihypertensive medication adherence among Scottish adults aged 65 years plus. Design: Pre-registration pharmacy trainees (pre-regs) undertaking postgraduate placement-in-practice based in community pharmacies across Scotland were invited to take part. Each pre-reg invited and consented up to 15 patients (aged 65 plus; at least one prescribed medication) presenting with a prescription which indicated treatment for hypertension, to take part in a telephone interview. Pre-regs added pharmacy dispensing data to a paper-based structured data collection tool for later online data entry. The structured interview focused on patient's beliefs about medicines and medication adherence. The study had NHS ethical approval. Results: Of the 130 pre-regs working in community pharmacy in Scotland 92% (n=119) took part with a patient-participant response rate of 75% (n=1332). 94% of respondents always-or-often strive to follow doctor's instructions and have a strict routine for use of their regular medicines. 87% rarely-or-never get confused about their medicines. 78% of respondents believed their medication prevented them becoming ill; unpleasant side effects were reported by 8%. 93% said taking medication did not disrupt their life. Respondents had visited a medical practice twice in previous 6 months. 69% reported normal blood pressure. 49% of respondents had previously smoked daily; 13% currently smoke. Conclusion: The SAAME study provides strong evidence of patients adhering to antihypertensive medication, also a model for promoting evidenced-based community pharmacy services: public health data year-on-year; raise the profile of clinical research in community pharmacy services. Feedback suggests pharmacies have concerns about telephone interviews preventing calls coming in so would prefer the option of face-to-face interviews; also direct online entry of data, and; online consent forms for the pre-regs. Future research is planned around evaluating pre-reg engagement, training needs, impact on community pharmacy based tutors and staff.