The University Record, September 16, 1998
By Nancy Ross-Flanigan
News and Information Services
Getting people with high blood pressure to take their medicine and watch their diets is a major challenge for the doctors who treat them. Many people feel no symptoms from the disease itself and are reluctant to take medicine that may cause unpleasant side effects. But the consequences of leaving high blood pressure (hypertension) untreated can be serious-diseases of the heart and arteries, stroke, kidney damage-and can shorten life expectancy by up to 16 years.
Could a little extra attention from the pharmacist who fills patients' prescriptions help keep them on course? A study under way in Detroit is designed to find out.
In the study, directed by researchers Stephanie Taylor, Eddie Boyd and Leslie Shimp of the College of Pharmacy, two Detroit independent pharmacies are offering extra services to hypertension patients enrolled in the project.
At each site, a pharmacist will work closely with about 25 patients, checking their blood pressure once a month, watching for drug side effects and suggesting any necessary medication changes to their doctors. At the beginning and end of the six-month study, patients will be given questionnaires that assess their quality of life, satisfaction with their medical care, and compliance in taking the medicine that has been prescribed for them.
The researchers hope to learn whether patients who get extra attention from pharmacists will be more likely to take their medicine and follow other recommendations aimed at getting their blood pressure under control. If the pharmacists' attention does make a difference, the U-M team wants to pinpoint exactly which services produce the greatest effects. While it may be impractical for pharmacists to offer intensive personal attention to large numbers of patients all the time, they could concentrate on delivering the kind of care that has the biggest benefit.
Although the study still is under way, pharmacist Mary Frazier of M&D Pharmacy in Detroit says she already sees a difference in a group of 10 patients she has been working with since April.
"So far, it's been working pretty well," says Frazier, a 1979 College of Pharmacy graduate who has practiced in Detroit for almost 20 years. "Surprisingly, many people don't realize that what they have is something they're going to have for life and something they need to keep under control every day. They think they can take a pill once a week when they get a headache." Monitoring patients' blood pressure and counseling them about diet and medicine has helped raise their awareness, she says. And keeping tabs on patients' progress also allows Frazier to work more closely with their physicians to make sure patients are taking the right combinations of drugs.
"A patient who only sees the doctor every 90 days may go 90 days with high blood pressure before they go back and get their medication changed," says Frazier. "When I'm monitoring a patient's blood pressure, I can tell the doctor right away if I think something needs to be added or changed."
The pharmacy project is part of a larger health research program through the Michigan Center for Urban African American Aging Research. The Center, which is a cooperative research arrangement among the U-M Institute for Social Research, Wayne State University and several community-based organizations in Detroit, is one of three aging centers in the nation funded by the National Institute on Aging.