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Pharmacist-Guided Optimization of Blood Pressure–Lowering Therapy in Patients with Associated Comorbidities
Corresponding Author(s) : Nandeesha D
International Journal of Allied Medical Sciences and Clinical Research,
Vol. 14 No. 1 (2026): 2026 Volume -14 - Issue 1
Abstract
Background: Hypertension commonly occurs with multiple comorbidities, increasing the complexity of treatment and the risk of drug interactions, medication errors, and poor therapeutic outcomes. Clinical pharmacists may improve treatment safety through prescription review, patient counselling, and medication-related interventions.
Methods: A prospective observational study was conducted among 450 hospitalized hypertensive patients in the Department of General Medicine at a tertiary care hospital from June 2023 to April 2025. Patient demographics, comorbidities, antihypertensive prescriptions, blood-pressure measurements, drug–drug interactions, medication errors, adverse drug reactions, and pharmacist interventions were evaluated. Prescription rationality was assessed using JNC 7 and Indian hypertension guidelines. Data were analysed using GraphPad Prism Version 5.
Results: Of the 450 patients, 265 (58.88%) were male and 185 (41.11%) were female, with the largest proportion aged ≥70 years (27.33%). Monotherapy was prescribed to 193 patients (42.88%), while 257 patients (57.11%) received combination therapy. Diuretics were the most frequently prescribed drug class (29.21%), followed by β-blockers (20.15%) and calcium channel blockers (20.00%). Amlodipine was the most commonly used monotherapy, whereas amlodipine plus atenolol was the most frequently prescribed two-drug combination. Most prescriptions (94.88%) were considered rational. Drug–drug interactions were frequently identified, highlighting the risks associated with polypharmacy and comorbidities. Clinical pharmacy services included counselling for 300 patients, identification of 24 medication errors, and monitoring of two adverse drug reactions. Several monotherapy and combination regimens produced clinically meaningful reductions in systolic and diastolic blood pressure.
Conclusion: Antihypertensive prescribing was largely rational, and combination therapy was frequently required to achieve adequate blood-pressure control. Clinical pharmacist participation contributed to the identification of medication-related problems, patient education, and safer antihypertensive treatment. Integrating clinical pharmacy services into routine hypertension management may improve medication safety and therapeutic outcomes.