EFFECTIVENESS OF PHARMACIST-LED PATIENT COUNSELING ON MEDICATION ADHERENCE AND HEALTH-RELATED QUALITY OF LIFE IN HYPERTENSIVE PATIENTS
Article Sidebar
Main Article Content
Abstract
Background: Hypertension is a major public health challenge in India, affecting approximately 66 million people. Poor
medication adherence remains a significant barrier to achieving optimal blood pressure control and improving the health
related quality of life (HRQoL). Objective: To assess the impact of structured patient education on medication
adherence, blood pressure control, and Health-Related Quality of Life in patients with hypertension. Methods: A
prospective, interventional, longitudinal cohort study was conducted over 25 months at the Warangal Hospitals
Diagnostics and Research Center, Telangana, India. A total of 507 patients with hypertension were randomized into the
test (intervention) and control groups. The test group received structured patient education through multiple modalities,
including oral counseling, patient information leaflets, audio-visual presentations, and home medication reviews. The
control group received routine care only. Medication adherence was assessed using the Brief Medication Questionnaire
(BMQ), HRQoL using the WHOQoL-BREF questionnaire, and clinical outcomes using blood pressure readings.
Statistical analysis was performed using ANOVA, multiple regression, and Pearson's correlation coefficient.
Results: The test group demonstrated significant improvement (P<0.0001) in medication adherence scores, with the 61
80 years age group showing the most pronounced improvement (ARS scores decreasing from 1.546 to 0.2314 in males
and from 2.0 to 0.8156 in females). WHOQoL-BREF domain analysis revealed that physical health contributed most
significantly to overall HRQoL (R²=0.0438, after intervention), followed by social relationships (R²=0.0246). Systolic
blood pressure decreased from 153.18 mmHg to 100.54 mmHg in the test group, while the control group showed
worsening from 121.84 mmHg to 157.84 mmHg. A very strong negative correlation was observed between medication
adherence and blood pressure (r=-0.9754, p=0.0048, R²=0.9514). Conclusion: Pharmacist-led structured patient
education significantly improved medication adherence, blood pressure control, and HRQoL in patients with
hypertension. The integration of clinical pharmacists into multidisciplinary healthcare teams is essential for effective
hypertension management.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
How to Cite
References
Biradar, S. S.; Reddy, Y. N., & Kumar, R. (2015). Pharmacist-mediated patient counseling on hypertension in compliance with quality of life in a South Indian city. Journal of Clinical and Diagnostic Research, 9(2), FC06-FC09.
Braverman, J., & Dedier, J. (2009). Predictors of medication adherence in African American patients diagnosed with hypertension. Ethnicity & Disease, 19(4), 396-403.
Cote, I., Gregoire, J. P., Moisan, J., et al. (2001). Quality of life in hypertension: A comparison of the SF-12 and SF-36. Value in Health, 4(3), 204-211.
Dallacosta, F. M., Schlindwein, N. C., & Giardini, E. F. (2025). Literacia em saúde e sua influência na adesão ao tratamento de hipertensos e diabéticos. Revista Interdisciplinar de Promoção da Saúde, 8(2).
Flack, J. M., Novikov, S. V., & Ferrario, C. M. (2006). Benefits of adherence to antihypertensive drug therapy. Journal of Clinical Hypertension, 8(6), 401-407.
Hadi, N., & Rostami-Gooran, N. (2010). Factors associated with medication compliance among hypertensive patients in an outpatient clinic. Journal of Hypertension, 28(5), 1-6.
Hall, J. E., & Guyton, A. C. (2006). Textbook of Medical Physiology. Elsevier Saunders.
Kearney, P. M., Whelton, M., Reynolds, K., Muntner, P., and Whelton, P. K., & He, J. (2005). Global burden of hypertension: Analysis of worldwide data. Lancet, 365(9455), 217-223.
Khaw, W. F., Hassan, S. T. S., & Latiffah, A. L. (2013). Health-related quality of life among patients with hypertension compared with general population norms. Quality of Life Research, 22(5), 1085-1093.
Korhonen, P. E., Kivela, S. L., & Kiuru, S. (2005). Health-related quality of life and awareness of hypertension. Journal of Human Hypertension, 19(4), 303-309.
Krzesinski, J. M., & Leeman, M. (2009). Patient education and involvement in hypertension management. Journal of Clinical Hypertension, 11(8), 456-462.
Melchiors A. C., Correr C. J., & Pontarolo, R. (2011). Quality of life in hypertensive patients: Validation of the Minichal-Brazil. Journal of Clinical Hypertension, 13(5), 359-365.
Nair K. V., Belletti D. A., Doyle J. J. (2009). Understanding intentional and unintentional non-adherence in patients with hypertension. Journal of Clinical Hypertension, 11(9), 482-489.
Osoro I, Amir M., Vohra M., Sharma, A. (2023). Pharmacist interventions in minimizing drug-related problems in diabetes with co-existing hypertension: A five-year overview and ground report from India. International Journal of Public Health, 68, 1605808.
Reeves, L., Robinson, K., McClelland, T., Adedoyin, C. A., Broeseker, A., & Adunlin, G. (2020). Pharmacist Interventions in the Management of Blood Pressure Control and Adherence to Antihypertensive Medications: A Systematic Review of Randomized Controlled Trials. Journal of Pharmacy Practice, 33(3), 480-492.
Sequiera, J., Pandya, S., Vala, S., Kapadia, N., Parihar, S. S., Patel, V., & Patel, D. (2025). Impact of Patient Counselling in Hypertensive and Diabetes Mellitus Type-II Patients. Research Journal of Pharmacy and Technology, 18(8), 3487-1.
Sidhu, H. K., Kaur, R., & Singh, J. (2024). Impact of hypertension, diabetes, and obesity on the quality of life in rural Punjab, India. Discover Public Health, 21, 242.
Stanley, E., Smith, S., and Jones, R. (2007). Quality of life in hypertensive patients following Hurricane Katrina. Journal of Clinical Hypertension, 9(4), 286-292.
Svarstad, B. L., Chewning, B. A., Sleath, B. L., & Claesson, C. (1999). The Brief Medication Questionnaire: A tool for screening patient adherence and barriers to adherence. Patient Education and Counseling, 37(2), 113-124.
Tadesse, T., et al. (2025). Impact of medication therapy management intervention on medication adherence among adult patients with comorbid diabetes mellitus and hypertension at outpatient clinics in Southwest Ethiopia: a cluster randomized controlled trial. Clinical Diabetes and Endocrinology 11, 41.
Tawhari M., Almalki F. H., Hawi A. M., Khormi H. A., Assiri, M. I., Musleh, Y. A. Y., & Shunaymir, A. M. (2024). Outcomes of counseling by pharmacists for patients with diabetes and hypertension: A systematic review. African Journal of Biomedical Research, 27(4S), 3405.
Wang, C., Lang, J., Xuan, L., Li, X., & Zhang, L. (2017). Association between health literacy, self-management efficacy, and health-related quality of life in patients with hypertension Journal of Clinical Hypertension, 19(8), 789-796.
Weber, M. A. (2002). Quality of life measured in a practice-based hypertension trial of an angiotensin II receptor blocker. Journal of Clinical Hypertension, 4(4), 256-263.
WHOQOL Group. (1997). WHOQOL: Quality of life measurement. Division of Mental Health and Prevention of Substance Abuse, World Health Organization, Geneva, Switzerland
WHOQOL Group. (1998). Development of the World Health Organization Quality of Life Assessment (WHOQOL-BREF). Psychological Medicine, 28(3), 551-558.
World Health Organization (WHO). (2003). Adherence to long-term therapies: Evidence for action. WHO Press.