(13) |
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After 6 months:
|
(14) |
|
After 6 months:
|
(15) |
If required, initial adjustment of diabetes medication and antihypertensive medication as suggested by the pharmacist
Structured diabetes education, including the importance of adherence and lifestyles that negatively affect blood pressure; providing patients with information leaflets
20 minute telephone consultations with the pharmacist every 8 weeks (topics: current medication, importance of adherence and treatment plan, possible concerns on the part of the patient)
n = 79 vs n = 77
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After 6 months:
Proportion of adherent patients on the basis of self assessment by Morisky score*
Reduction in systolic (ES 0.54)* and diastolic blood pressure (ES 0.41)*
Proportion of patients with blood pressure <130/80 mmhg*
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(16) |
Individual patient education about medication (about 1h)
Consultation with a pharmacist every other month (topics: adherence, medication if needed, prescriptions)
Packaging the drugs in calendar blister packs
n = 76 vs n = 83
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After 6 months:
Ratio of medication taken to medication prescribed (ES 2.06)*
Proportion of patients with adherence of at least 80%*
Blood pressure systolic (ES 0.49)* and diastolic (n.s.)
|
(17) |
Intervention 1: three telephone consultations with patients within 6 months (topics: reminder about appointments, finding out about medication intake; praise or encouragement if needed)
Intervention 2: three postal deliveries of written information materials within 6 months (topics: information about hypertension and correct medication intake; positive reinforcement; reminder of appointments)
n = 182 vs n = 184 and n = 172
|
After 6 months:
Ratio of medication taken to medication prescribed (ES 0.44 and 0.52)*
Blood pressure systolic (ES 0.23 and 0.24)* and diastolic (ES 0.46 and 0.27)*, measured by primary care physician, using Riva-Rocci
Difference of blood pressure systolic (ES 0.80)* and diastolic (0,21)* compared with baseline values for intervention 1
|
(18) |
|
After 6 months:
Ratio of medication taken to medication prescribed (electronically recorded by Monitoring Events Medication System“) (ES 1.11)*
Proportion of patients with good adherence (ratio of medication taken to medication prescribed 80–100%)*
Proportion of days when the correct dose was taken (ES 0.29)*
Proportion of days when medication was taken at the correct time (ES0.33)*
Blood pressure systolic (n.s.) and diastolic (n.s.), electronic double measurement
Reduction of blood pressure over the study period: systolic (n.s.), diastolic (ES 0.31)*
|
(19) |
Three quarterly meetings with pharmacists (topics including patient education, offer to check adherence)
Written information material
n = 99 vs n = 98
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After 9 months:
Proportion of patients with poor adherence (based on modified Morisky score)*
Proportion of patients who reached target blood pressure*
Blood pressure systolic (ES 0.40)* and diastolic (ES 0.33)*, electronically measured by nurses
|
(20) |
6-monthly individual meetings with pharmacists over 36 months (topics including identifying potential problems with adherence, importance of therapy for general health, administration of medication)
Individual plans for further proceedings, based on the results from the meetings
6-monthly group meetings (up to 20 participants) with pharmacists over 36 months (topics including adherence, risks of self-medication, dosages)
n = 100 vs n = 100
|
After 36 months:
Adherence on the basis of Morisky score*
Proportion of adherent patients on the basis of ratio of prescriptions issued to prescriptions filled (adherence here: 80–115%)*
Proportion of patients who reached target blood pressure*
|
(22) |
|
Over 6 months:
Ratio of medication taken to medication prescribed (ES 1.91)*
Proportion of medication taken at the correct time (ES 2.89)*
Blood pressure systolic (ES 0.17)* and diastolic (ES 0.16)*, triple determination by electronic device
|
(23) |
Individual patient education to achieve independent blood pressure monitoring, promote adherence, and enable detection of adverse events
10-minute telephone consultations with study nurse after 1 week, 1, 2, and 4 months (topics: questions about dosage, potential problems with medication, invitation to get in touch via telephone if required)
n = 76 vs n = 74
|
After 6 months:
Proportion of days when the correct dose was taken relative to the ‧respective prescription (electronic registration using Electronic Drug Event Monitor) (ES 0.41)*
Decrease in systolic (ES 0.46)* and diastolic blood pressure (ES 0.34)*, measured by using permanently installed sphygmomanometer in hospital
|
(24) |
Calendar blister pack
n = 38 vs n = 47
|
Over 12 months:
Calculated number of days covered by prescribed medication (medication possession ratio) (0.47)*
Number of prescriptions collected in time (ES 0.58)*
Blood pressure systolic (n.s.) and diastolic (ES 0.47)*
Hypertension-associated morbidity, n.s.
Admissions to hospital and visits to outpatient department, n.s.
|
(25) |
Written information material about disease and treatment
Lifestyle diary
Monthly blood pressure measurement by pharmacist
Monthly meeting with pharmacist for 30–50 minutes (topics: current medication, lifestyle, factors affecting blood pressure, problems with the therapy if required)
If required, recommendations for change in therapy to treating physician
n = 117 vs n = 118
|
After 6 months:
Proportion of patients with good adherence (= at least 80% of doses prescribed were taken)*
Blood pressure systolic (ES 0.20)* and diastolic (ES 0.24)*, measured by using sphygmomanometer in hospital
Reduction in systolic (ES 0.25)* and diastolic blood pressure (ES 0.23)*
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