Impact of Home Visits for Hypertension and Dyslipidemia by Community Pharmacists in Thailand: A Randomized Controlled Study

BACKGROUND: Limited time for counseling and infrequent follow-ups in pharmacies may affect clinical outcomes. While additional home visits by community pharmacists may improve outcomes in patients with hypertension and/or dyslipidemia, their impact in Thailand remains unstudied. The objective of this study was to compare clinical outcomes, medication adherence, and disease knowledge between patients with hypertension and/or dyslipidemia who received additional pharmaceutical care with home visits and those who received care only at a community pharmacy. METHODS: This randomized controlled study was conducted in a community pharmacy. Patients aged 20 years and older with uncontrolled hypertension and/or dyslipidemia were included. All patients received standard care in a community pharmacy dispensing service. A home visit by a pharmacist was conducted in the intervention group after 1 month and a telephone call after 3 months. Blood pressure (BP) and medication adherence were assessed at each visit, while low-density lipoprotein (LDL) cholesterol levels and disease knowledge were assessed at baseline and after 5 months. The primary outcome was the control of diseases by the end of the study. RESULTS: Seventy-five patients were included (38 and 37 patients in the home visit group and the control group, respectively). At the end of the study, systolic BP, diastolic BP, and LDL cholesterol levels were significantly lower in the home visit group compared with the control group (p < 0.05). Patients in the home visit group significantly achieved BP or LDL cholesterol targets compared with the control group (52.6% vs. 29.7% and 84.2% vs. 51.4%, respectively). In addition, more patients in the home visit group significantly achieved controlled hypertension from the second month (p < 0.05). Medication adherence and knowledge of hypertension and dyslipidemia were significantly higher in the home visit group compared with the control group (p < 0.05). CONCLUSION: The addition of home visits by a community pharmacist improved clinical outcomes, medication adherence, and disease knowledge.