Can a clinical pharmacy service added to usual care improve blood pressure control compared to usual care alone in a cohort of Sri Lankans?

Study setting(s) – Ragama Health study (RHS) Clinic, Faculty of Medicine, Ragama. Consecutive males and females with hypertension attending RHS clinic will be given a research ID stratified by sex and this will be indicated on the first page of the clinic book. Patients will be randomly assigned to intervention and control groups stratified by sex using the study ID. All patients with a study ID consisting of an “even number ‘ will receive intervention while the ones with an ID consisting of an “odd number “ will not receive the intervention. Intervention arm will receive advise by a clinical pharmacist in addition to usual care. Control arm will receive – usual care where the doctor will measure blood pressure and prescribe medicine and the hospital pharmacist will dispense medicine according to prescription. The intervention group will receive standard care together with “Clinical pharmacy intervention” at each clinic visit until 12 months from the recruitment. Routine clinic visits will be scheduled every 2 months according to the hospital policy unless the treating physician decides to see the patient earlier than routine.
The intervention includes: 1. Best possible medication history taking 2. Medicines reconciliation combining previous prescriptions and current prescriptions 3. Medication Order verification and correction after discussing with the physician if any errors of prescription noticed to prevent medication errors.
e.g: dose and dosing schedule, any interactions, deviations from the national BP guidelines 4. Individualized patient counseling on prescription: indication, direction of use, adverse drug reactions, interactions, storage of drugs, importance of compliance.

All consecutive, consenting male and female patients aged 40 years or older with hypertension who attend the Ragama Health Study clinic of Faculty of Medicine, Ragama, Sri Lanka.

1. Pregnant or lactating women.
2. Persons with advanced illness (e.g., those receiving dialysis or with liver failure), terminal illness, or a permanently bedridden individual are too ill to commute to the clinic regularly.
3. Persons living with psychosocial disabilities for whom instructions have not been adapted.