ABSTRACT
As part of the “Project to Promote Utilization of Pharmacies and Pharmacists as a Health Information Base” commissioned by the Ministry of Health, Labour and Welfare, the Saga Pharmaceutical Association carried out a self-measurement of blood glucose project in FY2014 and 2015. The present state of the Bioanalytical Labs in community pharmacies that participated in the self-measurement of blood glucose project nearly one and a half years ago was investigated. This project aimed to establish Bioanalytical Labs inside the community pharmacies to recommend hospital checkups to local residents based on the test results of self-measured blood glucose. In this study, a survey was given to those pharmacies to evaluate the present utilization status of the Bioanalytical Labs. About half of the pharmacies had canceled their Lab designation (46.4%). The most frequent reason for not continuing the designation was “Number of staff engaged in the measurement”, and that for continuing the designation, “To contribute to local residents self-medication”(53.6%). These pharmacies still promote self-measurements of blood glucose and encourage checkups to local residents who are above standard blood glucose levels and HbA1c and could be at risk of developing diabetes. Based on the above results, pharmacies that are continuing the Bioanalytical Labs have been shown to be used as bases for health support information in their local community. Therefore, while the shortage of pharmacists in rural areas is being pointed out, even from the viewpoint of promoting health support pharmacies, it is necessary to discuss seriously on how to secure the personnel required for continuing the Bioanalytical Labs.
ABSTRACT
Objectives In cardiology, resting heart rate (HR) and blood pressure (BP) are key elements and are used to adapt treatment. However HR measured in consultation may not reflect true resting HR. We hypothesize that there may be a “white-coat” effect like with BP and that there may be an association between HR variations and BP variations. Methods This prospective, monocentric, observational, pilot study (January-April 2016) included 57 consecutive ambulatory patients at Poitiers University Hospital, France (58% male, mean age 64 years). Patients’ resting HR and BP were recorded with the same automated blood pressure sphygmomanometer in consultation by the physician then with self-measurement at home. Results In the overall cohort, we found that HR was significantly higher in consultation (70.5bpm ± 12.6 vs. 68.1bpm ± 10.1, p = 0.034). HR also correlated with diastolic BP (r = 0.45, p = 0.001). Patients were divided into three groups to look for associations with BP: masked HR, (higher HR at home, 38.6%), white-coat HR, (lower HR at home 52.6%) and iso HR, (no change between HR at home and consultation, 8.8%). Although there was no difference between groups in diastolic BP measured in consultation, home diastolic BP was lower in the white-coat HR group (74.3 mmHg ± 9.8 vs. 77.9 mmHg ± 7.5, p = 0.016). Conclusions Our study brings to light an exciting idea that could have a major therapeutic and maybe prognostic impact in cardiology: resting HR measured by the physician in consultation does not reflect true resting HR. This must be taken into account to adapt treatment.