Exploring the Role of the Pharmacist in the Prevention and Management of Hypertensive Disorders in Pregnancy in Ashanti Region, Ghana

IF 2.7 3区 医学 Q2 PERIPHERAL VASCULAR DISEASE
Pauline Boachie-Ansah, Berko Panyin Anto, Afia Frimpomaa Asare Marfo, Edward Tieru Dassah, Morrison Asiamah, Ivan Eduku Mozu, Nana Ofori Adomako, Kwaku Gyamfi Oppong
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Abstract

Hypertensive disorders in pregnancy (HDPs) are a leading cause of poor maternal and birth outcomes worldwide. Prompt management of these disorders is usually recommended to optimize outcomes. Administration of pharmacotherapeutic agents is critical in the prevention and management of these disorders. The services of the pharmacist are required to maximize the benefits of drug therapy during prevention and management. There is a paucity of data on the effectiveness of pharmacist-led interventions in the management of these disorders in Ghana.

This study investigated the effect of a pharmacist-led intervention on knowledge, adherence to antihypertensive medication, and blood pressure (BP) control among pregnant women.

A quasi-experimental study was conducted. The study was carried out among pregnant women with moderate to high risk of developing HDPs and seeking antenatal care at a university hospital in Kumasi, Ghana. The pharmaceutical care model comprising health education, counseling, and medication administration reminders was provided fortnightly to study participants till delivery. Differences in pre- and post-intervention median scores were compared using the Wilcoxon signed-rank test.

The mean age was 35.7 years (± 1.2). The overall median knowledge and adherence scores increased significantly after the intervention by 11 versus 17 (p < 0.001) and 5 versus 9 (p < 0.001), respectively. Pharmaceutical intervention increased the proportion of mothers who were adherent by 68.9% (95% CI, 53.9–83.8%; p < 0.001). The commonest side effect of the two first-line antihypertensives (nifedipine and methyldopa) was headache. About 91% of the women delivered vaginally, and almost all (97.8%) of all deliveries were live births.

Pharmacist-led interventions had a positive impact on the knowledge of HDPs and adherence to antihypertensive medication in the study setting. Thus, incorporating pharmaceutical care into antenatal care would be worthwhile.

Abstract Image

探讨药师在加纳阿散蒂地区妊娠期高血压疾病预防和管理中的作用。
妊娠期高血压疾病(hdp)是全球孕产妇和分娩结局不良的主要原因。通常建议及时处理这些疾病以优化结果。药物治疗药物的管理是预防和管理这些疾病的关键。在预防和管理过程中,需要药剂师的服务来最大限度地发挥药物治疗的效益。在加纳,关于药剂师主导的干预措施在管理这些疾病方面的有效性的数据缺乏。本研究调查了药剂师主导的干预对孕妇降压药知识、依从性和血压控制的影响。进行了准实验研究。该研究是在加纳库马西的一所大学医院进行的,研究对象是患有HDPs并寻求产前护理的中度至高风险孕妇。药物护理模式包括健康教育、咨询和药物管理提醒,每两周提供给研究参与者,直到分娩。采用Wilcoxon符号秩检验比较干预前和干预后中位数得分的差异。平均年龄35.7岁(±1.2岁)。干预后,总体中位知识和依从性得分分别显著增加了11比17 (p < 0.001)和5比9 (p < 0.001)。药物干预使坚持服药的母亲比例增加了68.9% (95% CI, 53.9-83.8%;P < 0.001)。两种一线抗高血压药物(硝苯地平和甲基多巴)最常见的副作用是头痛。约91%的妇女顺产,几乎所有(97.8%)的分娩都是活产。在研究环境中,药剂师主导的干预对hdp的知识和抗高血压药物的依从性有积极的影响。因此,将药物保健纳入产前保健是值得的。
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来源期刊
Journal of Clinical Hypertension
Journal of Clinical Hypertension PERIPHERAL VASCULAR DISEASE-
CiteScore
5.80
自引率
7.10%
发文量
191
审稿时长
4-8 weeks
期刊介绍: The Journal of Clinical Hypertension is a peer-reviewed, monthly publication that serves internists, cardiologists, nephrologists, endocrinologists, hypertension specialists, primary care practitioners, pharmacists and all professionals interested in hypertension by providing objective, up-to-date information and practical recommendations on the full range of clinical aspects of hypertension. Commentaries and columns by experts in the field provide further insights into our original research articles as well as on major articles published elsewhere. Major guidelines for the management of hypertension are also an important feature of the Journal. Through its partnership with the World Hypertension League, JCH will include a new focus on hypertension and public health, including major policy issues, that features research and reviews related to disease characteristics and management at the population level.
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