The opportunity for community pharmacy to step in and support people with hypertension is huge, especially as drug adherence is so poor, said Liam Stapleton, pharmacist and managing director of Metaphor Development, at this year’s Pharmacy Show.

In an educational session supported by Omron, Mr Stapleton told delegates that badly managed blood pressure and a lack of drug adherence – which stands at 50-80 per cent of patients – means that hypertension can have a serious negative impact on people’s quality of life, especially as it is linked to so many serious health conditions such as stroke and heart disease.

But something as simple as a series of lifestyle interventions has the potential to reduce the need for medication and get blood pressure under control. Mr Stapleton referred to “a handy mnemonic” that pharmacy teams can work through with patients to cover all the important points. His Bed’s Bad mnemonic, linked to the idea that inactivity can have detrimental health effects, stands for:

  • Blood pressure. Is this monitored and carried out properly over a period of time?
  • Exercise – make sure people are meeting the national standard of 150 minutes of moderate intensity physical activity each week
  • Diet – the DASH diet, which is similar to Public Health England’s Eatwell Guide, should be followed, with particular attention made to salt reduction
  • Smoking. Reducing or stopping altogether, if possible
  • BMI reduction, although this should be taken in context as someone’s BMI might show they’re healthy when they’re actually overweight
  • Alcohol consumption should be reduced to less than 14 units a week for both men and women
  • Drug adherence – ask how patients use their medicines to see if they’re taking them properly. Listen and don’t judge.

Mr Stapleton highlighted the need to identify patients within the pharmacy who could benefit from implementing these lifestyle changes, linking it into healthy living pharmacy, if appropriate, as well as teaching people who do home monitoring how to do it properly. “When hypertension is monitored well, it can be managed better,” he said.


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