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The impact of short message services and personal consultation by pharmacy students on medication adherence and blood pressure control: study protocol for a cluster randomized trial

Authors Zhai P, Li Q, Gillani AH, Hayat K, Shi L, Wang S, Peng F, Xu S, Du Q, Cao Z, Morisky DE, Fang Y

Received 11 December 2018

Accepted for publication 13 March 2019

Published 30 April 2019 Volume 2019:13 Pages 627—636

DOI https://doi.org/10.2147/PPA.S197858

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 4

Editor who approved publication: Dr Naifeng Liu


Panpan Zhai,1–3 Qian Li,1–3 Ali Hassan Gillani,4 Khezar Hayat,1–3,5 Li Shi,1–3 Siyi Wang,1–3 Fei Peng,1–3 Sen Xu,1–3 Qianqian Du,1–3 Zeyu Cao,1–3 Donald E Morisky,6 Yu Fang1–3

1Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, People’s Republic of China; 2Center for Drug Safety and Policy Research, Xi’an, People’s Republic of China; 3Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an, People’s Republic of China; 4Department of Pharmacy, Yusra Institute of Pharmaceutical Sciences, Islamabad, Pakistan; 5Institute of Pharmaceutical Sciences, University of Veternary and Animal Sciences, Lahore, Pakistan; 6Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA 90095-1772, USA

Purpose: Hypertension prevalence is mounting at a great pace in the People’s Republic of China and poses a serious threat to health care systems. Medication nonadherence is one of the key factors in controlling high blood pressure. Our study uses two-arm cluster randomized controlled trial to investigate whether personal consultation by postgraduate pharmacy students and short message services (SMS) is effective in improving medication adherence and blood pressure control.
Patients and methods: The trial will involve 384 treated patients in 8 community health care centers (CHCs). The 8 CHCs will be randomly assigned to intervention and control group in a ratio of 1:1. Patients in the intervention group will receive a personal consultation which identifies the barriers to medication adherence and SMS reminders which will be sent at 3-day intervals while patients in the control group will receive standard pharmaceutical care. Personal consultation by pharmacy students will be delivered at months 0 and 3. SMS messages will include educational information about normal blood pressure, complications of hypertension, salt intake, healthy diet, smoking cessation, regular exercise, weight control, antihypertensive medication schedule and treatment. Both groups will be followed for 6 months in order to compare their medication adherence and blood pressure at months 0, 3 and 6. The primary clinical outcome is the change in mean blood pressure and medication adherence measured at baseline, months 3 and 6. Secondary outcome is the proportion of patients reaching controlled blood pressure at months 3 and 6.
Discussion: Pharmacy students led consultation will be conducted in the process of physical examination and SMS reminders which is at low cost, may be a feasible way to address the high prevalence of hypertension in the People’s Republic of China.

Keywords: medication adherence, hypertension, blood pressure, SMS reminders, personal consultation, community health care centers

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