Abstract P383: Pharmacist-led Digital Care Improved Community Hypertension Control by Increasing Medication Adherence in China

Objective: To identify the correlation between medication adherence and community hypertension control when a digital solution was introduced to assist retail pharmacists in a randomized controlled trial (RCT). Methods: Hypertensive patients (≥ 140/90 mm Hg, n=90) taking ARB or CCB anti-hypertensive drugs were recruited and randomized into 3 study groups: 1) usual care; 2) retail pharmacy in-store care which was offered as a walk-in service and provided by pharmacists who were equipped with the CareLinker solution consisting of blue-tooth BP monitor, an App and a cloud database to display history BP data, personalized meal plans and health coaching contents; or 3) home-based tele-medical care by which patients used GSM-embedded BP monitor to auto-send BP data to the pharmacists who then resorted to the CareLinker Decision Support Solution, a cloud-based backend engine, to consult patients over phone on a biweekly basis. This was a 12-month real-world research and the two primary end points were the anti-hypertensive medication adherence measured by Proportion of Days Covered (PDC) and changes of SBP. Results: PDC of the 3 study groups at baseline was 84.0% (group-1, control), 85.4% (group-2, pharmacy in-store intervention) and 87.6% (group-3, home-based tele-medical care), p > 0.05 between the 3 groups. At the end of the 12-month study, PDC was reduced to the annual average of 31.9% (group-1), 49.5% (group-2) and 61.2% (group-3), with p<0.05 between group-1 and the 2 intervention groups (group-2 and -3). Reduction of SBP was 3.4±2.4 mm Hg (p=0.166, group-1), 11.7±3.2 mm Hg (p=0.001, group-2), and 15.5±2.6 mm Hg (p=2.26*10 -6 , group-3), with p= 0.014 (group-1 vs group-2) and p= 0.002 (group-1 vs group-3). DBP was reduced by 3.2±1.5 mm Hg (p=0.043, group-1), 6.8±2.4 mm Hg (p=0.008, group-2), and 6.8±2.8 mm Hg (p=0.004, group-3). Plotting PDC with BP reduction found a strong positive correlation for SBP: r= 0.692, p<0.001, and a weaker correlation for DBP: r= 0.301, P=0.004. Conclusion: Pharmacist-led digital healthcare can improve adherence of anti-hypertensive medication by as much as 84% (group-3 vs group-1), leading to enhanced community BP control.