Resumen de Hypertension and socioeconomic status. Role of community pharmacist

María Raquel Miquel González, María Alpuente Climent, María Pilar D'Ocon Navaza, Lucrecia Moreno Royo

• Background: Hypertension management is a public health priority in most countries.A large number of hypertensive patients do not respond to antihypertensive treatment and many are detected after long history of high blood pressure (BP).An inverse correlation exists between socioeconomic status (SES) and BP. Several studies suggest that the establishment and implementation of a multidisciplinary healthcare team, including a pharmacist, may improve the quality of patient care.

  Objective: Analysing whether a close partnership between primary care physicians and community pharmacists may have an impact on the inverse correlation that exists between SES and lifestyle risk factors for hypertension.

  Method: Prospective observational study, carried out in four community pharmacies in Spain. BP was the mean of three measures. Information on SES and lifestyle was collected through a questionnaire. Statistical analyses performed using chi-square analysis and ANOVA. P <0.05 was considered statistically significant.

  Results: 677 patients were enrolled from the four pharmacies, one pharmacy was located in a rural area (No. = 190) with high SES and the others in a city: centre (No. = 179), middle-periphery (No. = 207) and outskirts (No. = 101) which has the lowest SES. In rural and outskirts, a close working relationship between physician and pharmacist existed. In contrast, both healthcare professionals worked independently in centre and middle-periphery. We found the highest rate of hypertension in outskirts, and the lowest in populations with the highest SES. In rural, we observed the highest proportion of hypertensive patients adequately controlled (60.4%); higher than national mean (40%).

  In outskirts, coincidently with a lower SES and greater cardiovascular risk factors, we observed lower percentage of hypertensive patients not previously diagnosed and a proportion of properly controlled hypertensive patients (50%),higher than national mean, may be due to the close working relationship between physician and pharmacist.

  Conclusions: SES and lifestyle have complex influence on hypertensive status but can be overcome with a close working relationship between primary care physicians and community pharmacists