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Published in: BMC Primary Care 1/2021

Open Access 01-12-2021 | Hypertension | Research article

A pharmacist health coaching trial evaluating behavioural changes in participants with poorly controlled hypertension

Authors: Harjit K. Singh, Gerard A. Kennedy, Ieva Stupans

Published in: BMC Primary Care | Issue 1/2021

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Abstract

Background

To investigate whether pharmacist health coaching improves progression through the stages of change (SOC) for three modifiable health behaviours; diet, exercise, and medication management in participants with poorly controlled hypertension.

Methods

In this four-month controlled group study two community-based pharmacists provided three health coaching sessions to 20 participants with poorly controlled hypertension at monthly intervals. Changes in participants’ stages of change with respect to the modifiable health behaviours; diet, exercise, and medication management were assessed. To confirm the behaviour change outcomes, SOC were also assessed in a control group over the same period.

Results

Statistically significant changes in the modifiable health behaviours- medication management (d = 0.19; p = 0.03) and exercise (d = 0.85; p = 0.01) were apparent in participants who received health coaching and were evident through positive changes in the SOC charts. The participants in the control group did not experience significant changes with respect to the SOC. This was parallel to a decrease in mean systolic blood pressure from session one to session four by 7.53 mmHg (p < 0.05, d = − 0.42) in participants who received health coaching. Improvements to medication adherence was also apparent in these participants, evident from the mean scores for the Adherence to Refills and Medications Scale (ARMS), which decreased significantly from a mean of 15.60 to 13.05 (p < 0.05) from session one to four.

Conclusions

Pharmacist health coaching produced promising health outcomes in participants with poorly controlled hypertension. Pharmacists were able to facilitate a positive behaviour change in participants. However, larger participant cohorts are needed to explore these findings further.

Trial registration

Australia New Zealand Clinical Trials Registry ACTRN12618001839​291. Date of registration 12/11/2018.
Appendix
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Literature
1.
go back to reference Arima H, Barzi F, Chalmers J. Mortality patterns in hypertension. J Hypertens. 2011;29:S3–7.CrossRef Arima H, Barzi F, Chalmers J. Mortality patterns in hypertension. J Hypertens. 2011;29:S3–7.CrossRef
2.
go back to reference Kjeldsen SE. Hypertension and cardiovascular risk: general aspects. Pharmacol Res. 2018;129:95–9.CrossRef Kjeldsen SE. Hypertension and cardiovascular risk: general aspects. Pharmacol Res. 2018;129:95–9.CrossRef
3.
go back to reference Sharman JE, Stowasser M. Australian Association for Exercise and Sports Science Position Statement on exercise and hypertension. J Sci Med Sport. 2009;12(2):252–7.CrossRef Sharman JE, Stowasser M. Australian Association for Exercise and Sports Science Position Statement on exercise and hypertension. J Sci Med Sport. 2009;12(2):252–7.CrossRef
4.
go back to reference Kelly DM, Rothwell PM. Blood pressure and the brain: the neurology of hypertension. Pract Neurol. 2020;20(2):100–8.CrossRef Kelly DM, Rothwell PM. Blood pressure and the brain: the neurology of hypertension. Pract Neurol. 2020;20(2):100–8.CrossRef
5.
go back to reference Wang Y-B, Kong D-G, Ma L-L, Wang L-X. Patient related factors for optimal blood pressure control in patients with hypertension. Afr Health Sci. 2013;13(3):579–83. Wang Y-B, Kong D-G, Ma L-L, Wang L-X. Patient related factors for optimal blood pressure control in patients with hypertension. Afr Health Sci. 2013;13(3):579–83.
6.
go back to reference Wolever RQ, Dreusicke M, Fikkan J, Hawkins TV, Yeung S, Wakefield J, et al. Integrative health coaching for patients with type 2 diabetes. Diabetes Educ. 2010;36(4):629–39.CrossRef Wolever RQ, Dreusicke M, Fikkan J, Hawkins TV, Yeung S, Wakefield J, et al. Integrative health coaching for patients with type 2 diabetes. Diabetes Educ. 2010;36(4):629–39.CrossRef
7.
go back to reference Byrnes JM, Goldstein S, Venator B, Pollicino C, Ng S-K, Veroff D, et al. The impact of population-based disease management services for selected chronic conditions: the costs to Australian private insurance-coaching health (CAPICHe) study protocol. BMC Public Health. 2012;12(1):114.CrossRef Byrnes JM, Goldstein S, Venator B, Pollicino C, Ng S-K, Veroff D, et al. The impact of population-based disease management services for selected chronic conditions: the costs to Australian private insurance-coaching health (CAPICHe) study protocol. BMC Public Health. 2012;12(1):114.CrossRef
8.
go back to reference Levinson W, Cohen MS, Brady D, Duffy FD. To change or not to change:“sounds like you have a dilemma”. Ann Intern Med. 2001;135(5):386–91.CrossRef Levinson W, Cohen MS, Brady D, Duffy FD. To change or not to change:“sounds like you have a dilemma”. Ann Intern Med. 2001;135(5):386–91.CrossRef
9.
go back to reference O'Connor M, Pugh J, Jiwa M, Hughes J, Fisher C. The palliative care interdisciplinary team: where is the community pharmacist? New Rochelle: Mary Ann Liebert, Inc.; 2011. O'Connor M, Pugh J, Jiwa M, Hughes J, Fisher C. The palliative care interdisciplinary team: where is the community pharmacist? New Rochelle: Mary Ann Liebert, Inc.; 2011.
10.
go back to reference Palmer S, Tubbs I, Whybrow A. Health coaching to facilitate the promotion of healthy behaviour and achievement of health-related goals. Int J Health Promot Educ. 2003;41(3):91–3.CrossRef Palmer S, Tubbs I, Whybrow A. Health coaching to facilitate the promotion of healthy behaviour and achievement of health-related goals. Int J Health Promot Educ. 2003;41(3):91–3.CrossRef
11.
go back to reference Neuner-Jehle S, Schmid M, Grüninger U. The “health coaching” programme: a new patient-centred and visually supported approach for health behaviour change in primary care. BMC Fam Pract. 2013;14(1):100.CrossRef Neuner-Jehle S, Schmid M, Grüninger U. The “health coaching” programme: a new patient-centred and visually supported approach for health behaviour change in primary care. BMC Fam Pract. 2013;14(1):100.CrossRef
12.
go back to reference Olsen JM, Nesbitt BJ. Health coaching to improve healthy lifestyle behaviors: an integrative review. Am J Health Promot. 2010;25(1):e1–e12.CrossRef Olsen JM, Nesbitt BJ. Health coaching to improve healthy lifestyle behaviors: an integrative review. Am J Health Promot. 2010;25(1):e1–e12.CrossRef
13.
go back to reference Singh HK, Kennedy GA, Stupans I. A systematic review of pharmacy health coaching and an evaluation of patient outcomes. Res Social Adm Pharm. 2019;15(3):244–51.CrossRef Singh HK, Kennedy GA, Stupans I. A systematic review of pharmacy health coaching and an evaluation of patient outcomes. Res Social Adm Pharm. 2019;15(3):244–51.CrossRef
14.
go back to reference Luder H, Frede S, Kirby J, King K, Heaton P. Health beliefs describing patients enrolling in community pharmacy disease management programs. J Pharm Pract. 2016;29(4):374–81.CrossRef Luder H, Frede S, Kirby J, King K, Heaton P. Health beliefs describing patients enrolling in community pharmacy disease management programs. J Pharm Pract. 2016;29(4):374–81.CrossRef
15.
go back to reference Herborg H, Haugølle LS, Sørensen L, Rossing C, Dam P. Developing a generic, individualised adherence programme for chronic medication users. Pharm Pract. 2008;6(7):148–57. Herborg H, Haugølle LS, Sørensen L, Rossing C, Dam P. Developing a generic, individualised adherence programme for chronic medication users. Pharm Pract. 2008;6(7):148–57.
16.
go back to reference DiDonato KL, May JR, Lindsey CC. Impact of wellness coaching and monitoring services provided in a community pharmacy. J Am Pharm Assoc. 2013;53(1):14–21.CrossRef DiDonato KL, May JR, Lindsey CC. Impact of wellness coaching and monitoring services provided in a community pharmacy. J Am Pharm Assoc. 2013;53(1):14–21.CrossRef
17.
go back to reference Wertz D, Hou L, DeVries A, Dupclay L Jr, McGowan F, Malinowski B, et al. Clinical and economic outcomes of the Cincinnati pharmacy coaching program for diabetes and hypertension. Managed Care (Langhorne, Pa). 2012;21(3):44–54. Wertz D, Hou L, DeVries A, Dupclay L Jr, McGowan F, Malinowski B, et al. Clinical and economic outcomes of the Cincinnati pharmacy coaching program for diabetes and hypertension. Managed Care (Langhorne, Pa). 2012;21(3):44–54.
18.
go back to reference Sutton K, Logue E, Jarjoura D, Baughman K, Smucker W, Capers C. Assessing dietary and exercise stage of change to optimize weight loss interventions. Obes Res. 2003;11(5):641–52.CrossRef Sutton K, Logue E, Jarjoura D, Baughman K, Smucker W, Capers C. Assessing dietary and exercise stage of change to optimize weight loss interventions. Obes Res. 2003;11(5):641–52.CrossRef
19.
go back to reference Shearer M, Kelly J, Lindner H, Menzies D, Taylor S. Coaching for behaviour change in chronic disease: a review of the literature and the implications for coaching as a self-management intervention. [special issue: the Management of Chronic Disease in primary care settings]. Aust J Prim Health. 2003;9(2–3):177. Shearer M, Kelly J, Lindner H, Menzies D, Taylor S. Coaching for behaviour change in chronic disease: a review of the literature and the implications for coaching as a self-management intervention. [special issue: the Management of Chronic Disease in primary care settings]. Aust J Prim Health. 2003;9(2–3):177.
20.
go back to reference DiClemente CC, Schlundt D, Gemmell L. Readiness and stages of change in addiction treatment. Am J Addict. 2004;13(2):103–19.CrossRef DiClemente CC, Schlundt D, Gemmell L. Readiness and stages of change in addiction treatment. Am J Addict. 2004;13(2):103–19.CrossRef
21.
go back to reference Linden A, Butterworth SW, Prochaska JO. Motivational interviewing-based health coaching as a chronic care intervention. J Eval Clin Pract. 2010;16(1):166–74.CrossRef Linden A, Butterworth SW, Prochaska JO. Motivational interviewing-based health coaching as a chronic care intervention. J Eval Clin Pract. 2010;16(1):166–74.CrossRef
22.
go back to reference Arafat Y, Ibrahim MIM, Awaisu A, Colagiuri S, Owusu Y, Morisky DE, et al. Using the transtheoretical model’s stages of change to predict medication adherence in patients with type 2 diabetes mellitus in a primary health care setting. DARU J Pharmaceut Sci. 2019;27(1):91–9.CrossRef Arafat Y, Ibrahim MIM, Awaisu A, Colagiuri S, Owusu Y, Morisky DE, et al. Using the transtheoretical model’s stages of change to predict medication adherence in patients with type 2 diabetes mellitus in a primary health care setting. DARU J Pharmaceut Sci. 2019;27(1):91–9.CrossRef
23.
go back to reference Sinclair HK, Bond CM, Lennox AS, Silcock J, Winfield AJ, Donnan PT. Training pharmacists and pharmacy assistants in the stage-of-change model of smoking cessation: a randomised controlled trial in Scotland. Tob Control. 1998;7(3):253–61.CrossRef Sinclair HK, Bond CM, Lennox AS, Silcock J, Winfield AJ, Donnan PT. Training pharmacists and pharmacy assistants in the stage-of-change model of smoking cessation: a randomised controlled trial in Scotland. Tob Control. 1998;7(3):253–61.CrossRef
24.
go back to reference Hudmon KS, Berger BA. Pharmacy applications of the transtheoretical model in smoking cessation. Am J Health Syst Pharm. 1995;52(3):282–7.CrossRef Hudmon KS, Berger BA. Pharmacy applications of the transtheoretical model in smoking cessation. Am J Health Syst Pharm. 1995;52(3):282–7.CrossRef
25.
go back to reference Marcus BH, Selby VC, Niaura RS, Rossi JS. Self-efficacy and the stages of exercise behavior change. Res Q Exerc Sport. 1992;63(1):60–6.CrossRef Marcus BH, Selby VC, Niaura RS, Rossi JS. Self-efficacy and the stages of exercise behavior change. Res Q Exerc Sport. 1992;63(1):60–6.CrossRef
26.
go back to reference Nguyen TMU, Caze AL, Cottrell N. What are validated self-report adherence scales really measuring?: a systematic review. Br J Clin Pharmacol. 2014;77(3):427–45.CrossRef Nguyen TMU, Caze AL, Cottrell N. What are validated self-report adherence scales really measuring?: a systematic review. Br J Clin Pharmacol. 2014;77(3):427–45.CrossRef
27.
go back to reference Park HY, Seo SA, Yoo H, Lee K. Medication adherence and beliefs about medication in elderly patients living alone with chronic diseases. Patient Prefer Adherence. 2018;12:175.CrossRef Park HY, Seo SA, Yoo H, Lee K. Medication adherence and beliefs about medication in elderly patients living alone with chronic diseases. Patient Prefer Adherence. 2018;12:175.CrossRef
28.
go back to reference Kromrey JD, Foster-Johnson L. Determining the efficacy of intervention: the use of effect sizes for data analysis in single-subject research. J Exp Educ. 1996;65(1):73–93.CrossRef Kromrey JD, Foster-Johnson L. Determining the efficacy of intervention: the use of effect sizes for data analysis in single-subject research. J Exp Educ. 1996;65(1):73–93.CrossRef
29.
go back to reference Adams A, Cox AL. Questionnaires, in-depth interviews and focus groups; 2008.CrossRef Adams A, Cox AL. Questionnaires, in-depth interviews and focus groups; 2008.CrossRef
30.
go back to reference Lamb R, Sissons Joshi M. The stage model and processes of change in dietary fat reduction. J Hum Nutr Diet. 1996;9(1):43–53.CrossRef Lamb R, Sissons Joshi M. The stage model and processes of change in dietary fat reduction. J Hum Nutr Diet. 1996;9(1):43–53.CrossRef
31.
go back to reference Swan W, Kilmartin G, Liaw S-T. Assessment of readiness to prevent type 2 diabetes in a population of rural women with a history of gestational diabetes; 2007. Swan W, Kilmartin G, Liaw S-T. Assessment of readiness to prevent type 2 diabetes in a population of rural women with a history of gestational diabetes; 2007.
32.
go back to reference Caponnetto P, DiPiazza J, Aiello MR, Polosa R. Training pharmacists in the stage-of-change model of smoking cessation and motivational interviewing: a randomized controlled trial. Health Psychol Open. 2017;4(2):2055102917736429.CrossRef Caponnetto P, DiPiazza J, Aiello MR, Polosa R. Training pharmacists in the stage-of-change model of smoking cessation and motivational interviewing: a randomized controlled trial. Health Psychol Open. 2017;4(2):2055102917736429.CrossRef
33.
go back to reference DiClemente CC, Prochaska J, Norcross J. In search of how people change. Applications to addictive behaviors. Am Psychol. 1992;47(9):1102–14.CrossRef DiClemente CC, Prochaska J, Norcross J. In search of how people change. Applications to addictive behaviors. Am Psychol. 1992;47(9):1102–14.CrossRef
34.
go back to reference Zimmerman GL, Olsen CG, Bosworth MF. A'stages of change'approach to helping patients change behavior. Am Fam Physician. 2000;61(5):1409–16. Zimmerman GL, Olsen CG, Bosworth MF. A'stages of change'approach to helping patients change behavior. Am Fam Physician. 2000;61(5):1409–16.
35.
go back to reference Shah B, Chewning B. Conceptualizing and measuring pharmacist-patient communication: a review of published studies. Res Social Adm Pharm. 2006;2(2):153–85.CrossRef Shah B, Chewning B. Conceptualizing and measuring pharmacist-patient communication: a review of published studies. Res Social Adm Pharm. 2006;2(2):153–85.CrossRef
36.
go back to reference Lonie JM, Austin Z, Nguyen R, Gill I, Tsingos-Lucas C. Pharmacist-based health coaching: a new model of pharmacist-patient care. Res Social Adm Pharm. 2017;13(3):644–52.CrossRef Lonie JM, Austin Z, Nguyen R, Gill I, Tsingos-Lucas C. Pharmacist-based health coaching: a new model of pharmacist-patient care. Res Social Adm Pharm. 2017;13(3):644–52.CrossRef
37.
go back to reference Arlot S, Celisse A. A survey of cross-validation procedures for model selection. Statistics Surveys. 2010;4:40–79.CrossRef Arlot S, Celisse A. A survey of cross-validation procedures for model selection. Statistics Surveys. 2010;4:40–79.CrossRef
38.
go back to reference Charness G, Gneezy U, Kuhn MA. Experimental methods: between-subject and within-subject design. J Econ Behav Organ. 2012;81(1):1–8.CrossRef Charness G, Gneezy U, Kuhn MA. Experimental methods: between-subject and within-subject design. J Econ Behav Organ. 2012;81(1):1–8.CrossRef
Metadata
Title
A pharmacist health coaching trial evaluating behavioural changes in participants with poorly controlled hypertension
Authors
Harjit K. Singh
Gerard A. Kennedy
Ieva Stupans
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2021
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-021-01385-0

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