Evaluation of a pharmacist-led medication therapy management program for patients with hypertension at a tertiary hospital’s outpatient clinic in Malawi
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Date
2020-10-16
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Kamuzu University of Health Sciences
Abstract
Type of Study: Prospective Parallel Cohort Study
Problem: Non-Communicable Diseases (NCDs) are causing significant morbidity and mortality
within Malawi’s population. In particular, hypertension is a chronic health problem that often is
under prioritized due to high prevalence of infectious diseases. The pharmacy profession is
underutilized in efforts to address hypertension in the public health system due to gaps in data
supporting ambulatory pharmacists’ inclusion in treatment.
Objectives: This parallel cohort study intends to evaluate blood pressure control and adherence
in patients receiving standard of care compared to patients receiving standard of care in addition
to an ambulatory care pharmacist’s services in a hypertension clinic. Secondary objectives
include evaluating goal blood pressure met in both study arms, determining types and quantity of
pharmacist interventions, and collecting data on satisfaction and feedback from other healthcare
professionals and patients.
Methodology: A trained ambulatory care pharmacist will be incorporated into the hypertension
clinic at Queen Elizabeth Central Hospital (QECH) from November 2020 to November 2021.
There will be two arms of the study: the control arm being standard of care offered at the clinic,
the intervention arm being standard of care plus the services of the aforementioned ambulatory
care pharmacists. This pharmacist will collect baseline demographic data and treatment status
along with treatment progression at follow-ups per the hypertension clinic’s guidelines.
Medication adherence will also be monitored between both groups by the pharmacist. Patient
satisfaction scores and feedback from the other members of the healthcare team will be
collected throughout the study. Analysis of blood pressure changes, patients achieving goal
blood pressure, and change in medication adherence will be conducted at 6 months and 12
months.
Expected Findings: The expected outcomes will display a statistically significant benefit in
health outcomes and adherence through the incorporation of an ambulatory pharmacist
compared to the current standard of care. These results will also reveal patient satisfaction
scores and healthcare provider feedback that will promote future inclusion of pharmacists in
NCD outpatient treatment.
Dissemination: The results will be presented at the 2021 International Pharmaceutical
Federation (FIP) World Congress of Pharmacy and Pharmaceutical Sciences in Seville, Spain.
The associated manuscript will be submitted to the peer reviewed Journal of Pharmacy Practice
for publication. In addition, the results will be presented to the Malawi Ministry of Health by the
pharmacy department at the College of Medicine to open discussion about creating ambulatory
pharmacist positions. Finally, the results will be shared with COMREC upon the completion of
the study.