According to the CDC, about 47% of adults in the United States have hypertension, and only 1 in 4 of those patients have their blood pressure under control. These patients come in and out of our pharmacies every day, and their pharmacy team is well poised to help them manage their blood pressure.
So how do we get the conversation started?
David Ford, pharmacy manager at Williams Brothers Health Care Pharmacy in Paoli, Indiana ordered an educational tool for hypertension that he uses to show patients how having high blood pressure can affect other parts of the body like the heart, eyes, and kidneys.
"The tool starts the conversation by itself. Patients are curious when they see it" - David Ford
A visual tool like this can really help patients picture why controlling their blood pressure is important. It can be really helpful to see since having high blood pressure isn't something we "feel" as much as other chronic conditions.
The American Heart Association also has a great "Hypertension Guideline Toolkit for Pharmacists" to help you feel prepared to talk with patients about high blood pressure, lifestyle modifications and medication management.
The toolkit can be accessed here: AHA High Blood Pressure Toolkit-Pharmacists (ascendeventmedia.com)
Once we have started the conversation, we can use various functions within our pharmacy dispensing system software to "flag" hypertension patients for follow-up, or further assessment at their next medication pick-up. Some question we can ask are included in the Hypertension Month 2 Change Package, or below with some additional probes:
In the past 14 days, how many days have you missed at least one dose of any [high blood pressure] medication?
What are your concerns with your medications and/or any challenges you have taking your medications as prescribed by your doctor? (cost, side effects, etc.)
What is your blood pressure goal? This may have been something you discussed with your doctor.
How often do you take your blood pressure at home or at a pharmacy? Do you write your measurements down? (offer BP card at the pharmacy to record)
How often do you eat food with a lot of salt, sugar, or animal fat? How often do you have sugary drinks or alcohol? (Have the patient describe what a day of meals looks like for them)
How many times per week do you exercise or engage in physical activity, like walking?
As we work through the Hypertension Progression, we can build on these questions to help patients identify ways to incorporate more physical activity, make dietary changes, check their blood pressure, and find a medication regimen that works well for them. Stay tuned for more tips and tricks!
What are your pharmacy's best practices for hypertension? Share below!
Katie Hettinger, PharmD
Community Practice Research Fellow at Purdue University
Team Lead for Team Indiana