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Impact of hospital pharmacist-delivered individualised pharmaceutical service intervention on clinical and patient-reported outcomes in patients with hypertension: a randomised controlled trial
  1. Nabina Paudel1,
  2. Shakti Shrestha2,3,
  3. Nirmal Raj Marasine4,
  4. Pitambar Khanal5,
  5. Sushant Aryal6,
  6. Daniel Erku7,8,
  7. Arjun Poudel3,9
  1. 1 School of Pharmacy, Kathmandu University, Dhulikhel, Nepal
  2. 2 School of Pharmacy, The University of Queensland, Brisbane, Queensland, Australia
  3. 3 Quality Use of Medicine Research Network Nepal, Chitwan, Nepal
  4. 4 Department of Pharmacy, Karnali College of Health Sciences, Kathmandu, Nepal
  5. 5 Department of Pharmacy, Nepalgunj Medical College, Nepalgunj, Nepal
  6. 6 School of Physical and Chemical Sciences, University of Canterbury, Christchurch, New Zealand
  7. 7 Centre for Applied Health Economics, Griffith University, Nathan, Queensland, Australia
  8. 8 Menzies Health Institute Queensland, Griffith University, Goldcoast, Queensland, Australia
  9. 9 School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
  1. Correspondence to Shakti Shrestha, School of Pharmacy, The University of Queensland, Brisbane, QLD 4102, Australia; shakti.shrestha{at}


Objectives Patients with hypertension in Nepal are often known to have poor medication adherence and quality of life. This randomised controlled trial aimed to evaluate the impact of a hospital pharmacist-delivered individualised pharmaceutical service (P-DIPS) intervention on blood pressure, medication adherence and health-related quality of life (HRQoL) among patients with hypertension in a hospital setting in Nepal.

Methods In an open trial, 56 adult patients with hypertension who had been receiving antihypertensive medication for ≥6 months were randomly allocated to a control group (n=28) which received the usual care and an intervention group (n=28) which received a P-DIPS along with the usual care. The difference in blood pressure, medication adherence and HRQoL between the two groups at baseline, 2 and 4 months was compared using the Mann–Whitney U test, independent t-test or χ2 tests.

Results Participants were mostly ≥40 years (86%) and female (57%). There were no significant differences in the baseline characteristics between the control (C) and intervention (I) groups. At 2 months, the two groups had a significant improvement in the median (IQR) Morisky–Green–Levine (MGL) Medication Adherence Score (I=1 (2) vs C=2 (2); p<0.001) and the median (IQR) mental component of HRQoL (I=43.6 (9.5) vs C=37.5 (8.6); p=0.013). At 4 months, there were significant differences in the median (IQR) values of all the outcome measures between the groups (systolic blood pressure: I=125 (10) mmHg vs C=130 (15) mmHg, p=0.008; diastolic blood pressure: 80 (14) mmHg vs 90 (10) mmHg, p=0.012; MGL score: I=1 (1) vs C=2 (1), p<0.001; physical component of HRQoL: 45.0 (9.0) vs 40.3 (8.2), p=0.046; and mental component of HRQoL: 47.1 (11.1) vs 38.8 (8.5), p=0.003).

Conclusions The findings suggest that a P-DIPS intervention in the hospital setting of Nepal has a significant potential to improve blood pressure, medication adherence and HRQoL in patients with hypertension.

  • pharmacy service
  • hospital
  • randomized controlled trial
  • hypertension
  • health services administration
  • primary health care
  • communicable diseases

Data availability statement

Data are available upon reasonable request.

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