PHARMACIST-PROVIDED SELF-MONITORING TOOLS AND TRAINING: A PATHWAY TO BETTER BLOOD PRESSURE CONTROL AND SELF-MANAGEMENT IN DIABETIC PATIENTS- A PROSPECTIVE STUDY FROM GANDHINAGAR, GUJARAT

Abstract

Background: Self-monitoring of blood pressure (BP) and blood glucose is essential for effective diabetes and hypertension management. However, patient engagement in self-monitoring practices remains suboptimal. This study evaluates the impact of pharmacist-provided self-monitoring tools, educational guides, and structured documentation on patient engagement and its association with BP control among diabetic patients with uncontrolled hypertension. Objective: To assess the impact of pharmacist-provided self-monitoring tools on device utilization, correct technique, documentation completion, and progression from family-dependent to independent self-monitoring, and to evaluate the association between self-monitoring engagement and BP control. Methods: This prospective interventional study enrolled 105 diabetic patients with uncontrolled hypertension (BP ≥130/80 mmHg) at two tertiary care hospitals in Gujarat, India. Patients were followed at baseline, 8, 16, and 24 weeks. The pharmacist intervention included educational brochures, guided self-monitoring instructions, structured documentation logs (BP/blood sugar/insulin), hands-on training, and progressive independence training. Primary outcomes were device utilization, correct technique, documentation completion, and self monitoring independence. Results: At 24 weeks, BP self-monitoring increased from 18.1% to 45.7% (p<0.001), blood glucose self monitoring from 21.0% to 49.5% (p<0.001), correct BP technique from 11.4% to 52.4% (p<0.001), and correct blood glucose technique from 13.3% to 55.2% (p<0.001). Documentation completion was 48.6% for BP logs, 52.4% for blood sugar logs, and 65.1% for insulin logs. Independence in self-monitoring increased from 26.7% to 72.4% (p<0.001), while family dependency decreased from 17.1% to 8.6% (p<0.05). Mean SBP reduced from 143.0±7.4 to 138.2±9.8 mmHg (p<0.001), mean DBP from 92.0±6.3 to 85.1±6.8 mmHg (p<0.001), and 52.4% achieved target BP (<130/80 mmHg). Independent self-monitors achieved significantly lower SBP (135.2±8.0 vs. 140.8±10.5 mmHg, p<0.01) and higher target achievement (64.5% vs. 20.7%, p<0.001). Conclusion: Pharmacist-provided self-monitoring tools and progressive training significantly enhance self monitoring engagement, successfully transition patients from family-dependent to independent monitoring, and are positively associated with improved BP control. This practical, scalable model offers an effective approach to empowering patients in chronic disease self-management.