Pharmacist-led ambulatory blood pressure monitoring in community pharmacy : an operational feasibility case series

Abstract

Objectives: To evaluate the operational feasibility of pharmacist-led ambulatory blood pressure monitoring (ABPM) in community pharmacy practice.

Materials and Methods: This operational feasibility case series recruited eligible participants from four community pharmacies located in three geographical districts in Malta over a three-month recruitment period. Process feasibility included recruitment uptake and participant acceptability. Management feasibility included the completion of a valid 24-hour ABPM recording and successful tracking of post-referral outcomes. Pragmatic post-hoc benchmarks were applied: uptake of at least 60%, completion of valid recordings of at least 80%, and post- referral outcome tracking of at least 80%. Exact 95% confidence intervals (CIs) were calculated using the Clopper-Pearson method.

Results: Ten of 20 invited participants consented, corresponding to an uptake rate of 50% (95% CI, 27.2–72.8%). Valid 24-hour ABPM recordings meeting the pre-defined recording quality criteria were obtained for 9 of the 10 participants, corresponding to a completion rate of 90% (95% CI 55.5–99.7). 4 participants were referred for physician review, and post-referral outcomes were obtained for all 4 participants, corresponding to a tracking rate of 100% (95% CI 39.8–100.0). Three of the 4 referred participants reported an intensification of their antihypertensive treatment.

Conclusion: Pharmacist-led ABPM in community pharmacies demonstrated operational feasibility regarding completion of valid recordings and post-referral tracking, although uptake requires improvement. Participant-reported treatment changes should be interpreted as exploratory signals, and larger implementation studies are warranted.