Three Case Reports of Periodic Health Consultations with Collaboration among Pharmacists and Physicians in a Doctorless Area that Contributed to Improvement in Cases of Hypertension

Abstract

Optimal blood pressure (BP) control is extremely important because hypertension is a risk factor for stroke, and heart and blood vessel disease. We have been performing periodic health consultations with collaboration among pharmacists and physicians in a doctorless area. We here report three cases in which these consultations contributed to improvement in hypertension. The first consultation involved a woman in her 70s who feared starting an antihypertensive drug after hypertension had been diagnosed during a medical checkup. After introducing interventions based on lifestyle modifications and home BP measurements, her BP stabilized without medication. The second consultation, with a woman in her 50s, had been taking tofisopam and captopril for autonomic nervous symptoms and hypertension, respectively. The consultation occurred after she had redeveloped marked hypertension caused by ceasing tofisopam of her own accord. She agreed to resume taking this drug again, after which her BP dropped to normal levels. The third consultation, with a woman in her 80s, was suspected of having hypertension induced by pseudo-aldosteronism caused by long-term use of an herbal medicine containing licorice. We recommended consultation with a primary care doctor, after which she discontinued taking the herbal medicine. Health interviews, active listening, BP measurement, and recommendations for lifestyle modifications and appropriate drug use provided by pharmacists, as well as coordination with primary care doctors and medical specialists, are useful for managing hypertension in residents of doctorless areas.