Hypertension or increased blood pressure is a medical condition that can have a significant impact on human health. In particular, it is well known to have a detrimental effect on the cardiovascular system. Blood pressure control remains a serious nationwide challenge, as it requires a systematic approach and active engagement of patients and medical professionals. Studies show that frequent data collection, regular updates of the guidelines, and the use of single-pill treatments result in significant improvements in public health. This paper provides several examples of patient interventions, which could prove useful in increasing the efficiency of the practice.
One of the major issues associated with poor blood pressure control is patients’ medication nonadherence. Over 50% of the patients diagnosed with medication-resistant hypertension, in fact, do not take their drugs regularly (Morawski et al., 2018). As a result, monitoring the efficiency of treatments becomes extremely difficult. Studies show that using a smartphone app could increase medication adherence (Morawski et al., 2018). Medisafe app, for example, can be linked to a medication record, and it reminds a patient when they should take their drugs (Morawski et al., 2018). Moreover, it can be set to send alerts to a family member or a friend if the patient misses his dose, increasing the level of control (Morawski et al., 2018). Hence, I would strongly recommend the patients with high blood pressure to use an app to ensure higher medication adherence. Self-reports will be used to evaluate the efficiency of the measure.
There are several positive outcomes of using the app to consider. Firstly, it would allow the NP to monitor the efficiency of drug therapy and make timely adjustments. Secondly, it would decrease the percent of the patients with falsely diagnosed medication-resistant hypertension, reducing the NP’s workload. Lastly, it would improve patient outcomes due to the increased adherence to the therapy.
Single-pill Combination Therapy
In recent years, numerous studies have proven the efficiency of single-pill combination therapy. Single-pill combinations have shown to reduce blood pressure more efficiently than double-pill treatments (Mourad et al., 2017). They also contribute to increasing adherence among the patients. After switching to single-pill therapy, almost half of the patients show perfect adherence, compared to only 20% among those using different treatments (Fleig et al., 2018). Most importantly, it leads to faster achievement of blood pressure goals, which reduces the risk of cardiovascular diseases (Nedogoda & Stojanov, 2017). Therefore, I believe that prescribing single-pill combination therapy would benefit the patients with hypertension immensely.
Promoting single-pill therapy would increase the levels of adherence and the efficiency of treatment. Hence, it would improve outcomes for patients with high blood pressure. It could prove especially valuable for the ones with increased cardiovascular risks, as it leads to faster achievement of blood pressure goals. Patients with additional medical conditions who take other drugs are more likely to accept this treatment as opposed to taking several pills or increasing the dosage of the drug. Jaffe et al. (2013) also note that single-pill combination therapy is cheaper than the alternatives. Overall, besides the efficiency of the treatment, the simplicity and the reduced patient costs are the key factors, which can improve NP patient ratings.
Medical Assistant Follow-Up Visits
Frequent data collection plays an essential role in prescribing and adjusting medical treatments. In one of the most successful large-scale hypertension control programs, KPNC, multiple measures were introduced to increase blood pressure control efficiency, including additional medical assistants’ visits (Jaffe et al., 2013). Trained assistants visited patients to collect follow-up measurements within 2-4 weeks after changing their medication (Jaffe et al., 2013). While it is difficult to evaluate the efficiency of particular measures used in the program, overall, it has proven to be extremely effective in improving blood pressure control in Northern California (Jaffe et al., 2013). Hence, I would suggest using follow-up visits to improve data collection accuracy and increase the flexibility of the treatment programs.
This measure provides numerous benefits for both patients and clinicians. Patients would appreciate the convenience of the service, as they gain better access to the medical team and save a lot of time. On the other hand, these visits lead to optimization of the workflow of the medical professionals, as the data can be collected by ancillary staff (Jaffe et al., 2013). Regular follow-up measurements are key to adjusting the therapy to ensure its effectiveness. While it might be difficult to measure the statistical efficiency of this approach, it would certainly improve overall feedback from the patients.
While hypertension remains a serious public health concern in the US, numerous studies suggest that implementing a system-based approach in healthcare could significantly reduce risks associated with high blood pressure. The proposed interventions promote better access to medical services and increased efficiency of the treatment for the patients, as well as reducing the workload of the medical staff. Overall, these measures would greatly improve the quality of medical care provided by a facility without significantly increasing operating costs.
Fleig, S. V., Weger, B., Haller, H., & Limbourg, F. P. (2018). Effectiveness of a fixed-dose, single-pill combination of perindopril and amlodipine in patients with hypertension: A non-interventional study. Advances in Therapy, 35, 353-366.
Jaffe, M. G., Lee, G. A.,Young, J. D.,Sidney, S., & Go, A. S. (2013). Improved blood pressure control associated with a large-scale hypertension program. JAMA, 310(7), 699–705.
Morawski, K, Ghazinouri, R, Krumme, A, Lauffenburger, J. C., Lu, Z., Durfee, E., Oley, L., Lee, J., Mohta, N, Haff, N, Juusola, J. L., & Choudh, N. K. (2018). Association of a smartphone application with medication adherence and blood pressure control. The MedISAFE-BP randomized clinical trial. JAMA International Medicine, 178(6), 802-809.
Mourad, Jean-Jacques, Amodeo, C., de Champvallins, M., Brzozowska-Villatte, R., & Asmar, R. (2017). Blood pressure-lowering efficacy and safety of perindopril/indapamide/amlodipine single-pill combination in patients with uncontrolled essential hypertension. Journal of Hypertension, 35(7), 1481-1495.
Nedogoda, S. V., & Stojanov, V. J. (2017). Single-pill combination of perindopril/indapamide/amlodipine in patients with uncontrolled hypertension: A randomized controlled trial. Cardiology & Therapy, 6, 91-104.