Essay On Hypertension

Blood pressure is a physiological measurement and would need specific measurement for the prescribing of anti-hypertensives

Cooper L.A., & Roter D.L., & Carson K.A., & Bone L.R., & Larson S.M., & Miller E.R. III, & Levine D.M. (2011). A randomized trial to improve patient-centered care and hypertension control in underserved primary care patients. Journal of General Internal Medicine, 26, 1297 â[euro]" 1304. 10.1007/s11606-011-1794-6

With the huge shift in the U.S. healthcare system, healthcare services are now trending towards value-based outcomes.1 With passage of the Affordable Care Act (ACA), it has become increasingly important to improve quality of care while simultaneously reducing health care costs.2 Pharmaceutical care services are one of the key components that has an essential impact on optimizing therapy outcomes; minimizing cost and enhancing quality of life of chronically ill patients. Community pharmacists are the third largest healthcare provider group in the world after physicians and nurses.3 Despite the fact that many studies have shown that community pharmacists’ provision of direct patient care can lead to improved patient outcomes and reduced health care costs. However, community pharmacists are the only health professionals who are not primarily rewarded for delivering health care and hence are under-utilized as public health professionals.3 Community pharmacists could help to improve health by reducing drug-related adverse events and promoting better medication adherence, which in turn may help in reducing unnecessary provider visits, hospitalizations, and readmissions while strengthening primary care delivery across the health system.

Two patient verifier completed. Per PA Wu , the patient was informed that she has added an additional bp med to his current regimen. Asked the patient that he has any swelling in legs. The pt says no. Informed the patient that only a 30 day supply was ordered on his Lisinipril. Please record bp readings for the next seven days at the same time then email reading via Micare. If bp in not controlled then a f/u with his provider is needed. The patient agrees and verbalized

Many organizations have developed practice guidelines for a myriad of clinical scenarios which include the use of specific drugs or classes of medications, typically in a step-wise pattern. These “Best Practice” guidelines are built on evidence based criteria and systematic reviews. It has been shown that these clinical guidelines, with their list of essential medications, improve the quality of care and lead to better outcomes, but have not been shown to reduce costs.4,5 The practice of medicine has moved dramatically towards the use of these guidelines in recent years. For example, best practices for diabetic care recommends that all patients be placed on an ACE (angiotensin converting enzyme) inhibitor or ARB (angiotensin receptor blocker) for prevention of diabetic nephropathy and a statin for prevention of coronary artery disease. However, each patient’s insurance may cover a different medication in this class

Many patients are finding it more difficult to afford their prescription medications. Comparing health care expenditures in the United States, prescription drug costs rank third compared to hospital expenses and physician services (Omojasola, Hernandez, Sansgiry, & Jones, 2012, p. 479). The rising cost of prescription drugs is concerning to many patients. “The high out-of-pocket prescription drug cost is associated with medication non-adherence and adverse health outcomes” Omojasola, et al., 2012, p. 480).

Efficacy is defined as the ability to produce the desired result (“Efficacy,” n.d.). One way to establish efficacy is to test the knowledge of the health care providers. The blood pressure program will be ineffective if the providers lack HTN knowledge. The author will plan to evaluate fluctuations in employee knowledge, attitudes, and viewpoints about blood pressure screening and control. Furthermore, the health care team members need to understand how to measure a manual blood pressure adequately. Accurate blood pressure readings will facilitate more validity in the results (CDC, 2014). Efficiency distinctly represents the ability to accomplish tasks in the least amount of time and effort (“Efficiency,” n.d.). Measurement tools used for determining efficiency will be proper staffing, working equipment, various sizes of blood pressure cuffs, and acceptable space for the program. Quality is the characteristic or feature that something possesses (“Quality,” n.d.). Trained health care providers will aid the program in obtaining good quality. Also, new sphygmomanometer that are calibrated and education pamphlets will serve as increasing the quality of the program.

In order to evaluate and compare medication compliance the patient’s discharge medication reconciliation were compared to patient’s medication list at time of first office visit. Of the patients in population 1 (N=82), 71 were seen back for follow up and 11 never returned. Of the 71 that returned for follow up 97.18% (N=69) were compliant with discharged core measure medications. Population 2 (N=104), 97 were seen back for follow up with 7 never returned. Of the 97 seen back for office follow up 100% (N=97) were compliant with discharged core measure medications. Statistical analysis of the two population did not find a statistically significant difference (p= 0.0991).

The convenience sampling that was used in recruiting all male patients who were on blood pressure medications is a glaring bias in this study. There was no information provided addressing why the patients were presenting to the clinic. There are many interventions that can raise blood pressure. For example, the study conducted by Marshall, Anantharachagan, Choudhary, Chue and Kaurhis, (2002) investigated the effect of situational anxiety on blood pressure experienced in anticipation of a blood test. Marshall, et. al., (2002) found that anticipation of a blood test can raise blood pressure. Foster-Fitzpatrick, et. al., 1999 did not address the purpose of the patient’s visit to the clinic.

Educating the patients about medications side effects is important as most patients are noncompliant due to side effects. Teaching patients to monitor blood pressure and heart rate using the return demonstration is important when taking the medications and the need to call the primary care physician for

Another topic that is underlined throughout the book was Andie’s non-adherence to her insulin shot and other medications. Throughout the book, Andie has demonstrated many incidences of non-adherence. Andie does not use her needles properly and has intentionally miss insulin shots to lose weight. The reason behind her behavior can be explained by the “Health Belief Model” in the Adherence and Behavior section of PHRM 826 Patient Centered Care. For patients to take action, they need to have high perceived threat from not taking the action. Threat is influenced by severity of non-adherence and susceptibility of those severities. For Andie, she definitely has high perceived severity from knowledge of possible complications of diabetes from

O’Brien E. The value of 24 h BP monitoring to assess the efficacy of anti-hypertensive drug treatment. Hot Topics in Hypertens 2011; 4:7–23.

The provision of written medication information given to the patient helps significantly in cases of medication non compliance (McGraw & Drennan 2004). This is because it aids in memory retention and presents patients with access to a reliable source of concise medication information, particularly if the patient needs to be reminded of certain aspects (Gorgos 2006). These written medication information sheets need to be provided in the patients primary, dominant language because it reduces the difficulty and limits barriers to patient understanding (Gorgos 2006).This is important because this intervention aims to increase a patient’s understanding of their medications, and when a patient feels more competent with the use of their medications, reduced

They were five double blind, placebo controlled trials for Candesartan celexetil hydrochlorothiazide, which we're eight weeks to twelve weeks in duration. The combined study sample consisted of 3,037 hypertensive patients and dosage ranged from 2 to 32 mg Candesartan celexetil and from 6.25 to 25 mg hydrochlorothiazide administered once daily in several combinations (www.centerwatch.com).

First goal: Patient will verbalize understanding of the importance of follow her heart medication regime as doctor prescribed it and describe the possible consequence of a non-compliance with her treatment by the end of her today’s appointment.