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NPA-backed pilot aims to test 2,000 pharmacy patients for hypertension

Twelve pharmacies across Essex are aiming to screen 2,000 patients for hypertension and atrial fibrillation (AF) as part of a National Pharmacy Association (NPA) pilot.

The NPA, with support from Essex local pharmaceutical committee (LPC), launched the first phase of the pilot last month (May 16), which involves “developing a standardised blood pressure screening protocol” (see below).

This phase will run until September, after which the 12 pharmacies will focus on initiating hypertension treatment with patients, something that “has not been done before”, NPA chief pharmacist Leyla Hannbeck claimed.

“People are going around like a ticking time bomb, not knowing [they] have a problem with hypertension until it is too late,” she added.

“We want pharmacy to detect and manage undiagnosed hypertension because we know that it is a big issue in communities.”

The “secondary aim” of the service is to identify individuals with undiagnosed AF, as “the blood pressure devices used in the initial readings [of hypertension] also have AF functionality”, Ms Hannbeck explained.

The NPA hopes the service will reduce pressure on GPs and allow patients to be screened and treated closer to home. It is in discussions with Anglia Ruskin University to evaluate the pilot, Ms Hannbeck said.

The evidence collected through the pilot will help “pave the way for the next steps of managing long-term conditions in community pharmacies”, in the hope that these services will then be commissioned nationally, she added.

No payment for pharmacies "at the moment"

Pharmacies will not be paid to provide the service “at the moment”, but the NPA and Essex LPC have provided funding for the equipment and “robust training”, Ms Hannbeck stressed.

Both the Department of Health and Social Care and Public Health England are aware of and have expressed “interest” in the service, she added. “Even the pharmacy minister has been briefed.”

The NPA is also in correspondence with the Pharmaceutical Services Negotiating Committee, other LPCs and clinical commissioning groups about the pilot.

The NPA wants to be able to demonstrate with “backed-up data” that patients can be tested and treated for hypertension in a community pharmacy, Ms Hannbeck said.

What will happen in each stage of the pilot?

Phase one:

  • Develop a standardised blood pressure screening protocol and introduce ambulatory blood pressure monitoring (ABPM)
  • Pre-screen patients for a number of lifestyle and risk factors, including smoking status, weight, exercise levels, family history and other relevant medical history
  • Measure patients' blood pressure and interpret in a "patient-friendly format", using a visual aid to assist understanding
  • If the readings indicate hypertension, offer the patient an ABPM 24-hour measuring device. Home blood pressure monitoring will be offered if ABPM is not suitable.

Phase two:

  • The initial blood pressure reading protocol will remain the same. Following diagnosis of hypertension, pharmacists will provide treatment under a patient group direction
  • Prior to start of treatment, patients will undergo a cardiovascular risk assessment, involving sending blood tests to a laboratory for analysis.

Source: NPA

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