Evaluating the role of pharmacists and m-Health strategies in the management of hypertension in General Pueyrredon

高血压是阿根廷主要的心血管危险因素之一，也是造成大量疾病和死亡的原因。虽然对有效治疗和预防策略有广泛的了解，但存在一个差距，限制了将这些知识转化为患者，特别是贫困患者的利益。几乎一半的高血压患者不知道自己的病情，大多数患者没有得到适当的控制。造成这种差距的主要问题是，由于多种障碍而无法获得保健服务，以及患者缺乏对控制和治疗的坚持。药剂师与卫生系统的结合和整合以及信息和通信技术（ict）的使用在改善这种情况的管理方面显示出非常有希望的结果；然而，它们在阿根廷很少使用。2018年，布宜诺斯艾利斯省Pueyrredón市卫生秘书处推动了一项创新社区计划，将药剂师纳入市卫生系统，并建立了一个虚拟平台（“健康MGP”，https://saludmgp.rpmplay.com/）和一个针对高血压患者的移动应用程序。药剂师的加入将改善病人获得保健服务的机会，因为大多数人在家附近都有药房，他们不需要安排轮流就诊。此外，药剂师将通过血压、咨询和药物使用监督等方式合作进行患者随访。虚拟平台将允许高血压患者成为虚拟社区的一部分，其他高血压患者和卫生专业人员可以参与其中，患者可以与其他人互动并积极参与疾病管理。该移动应用程序将向高血压患者发送提醒，以支持他们参与该计划，并加强对建议的遵守。我们提出了一项混合研究，以评估该计划的可获得性、可接受性、采用性和影响，并将这一经验作为案例研究，以促进政策和法律领域主要利益相关者之间关于药剂师参与卫生系统以及在非传染性疾病和高血压管理中使用信息通信技术的辩论。这些技术的结合不仅构成了慢性病管理的未来，而且代表了护理范式的转变。通过患者积极参与疾病的自我管理，它们有助于将卫生系统从基本上被动的转变为主动的。

Hypertension is one of the main cardiovascular risk factors in Argentina and the cause of a high number of diseases and deaths. Although there is extensive knowledge about effective treatments and preventive strategies, there is a gap that limits the translation of this knowledge on the benefits of the patients, especially of the poorer ones. Almost half of hypertensive patients do not know their condition and most of them are not appropriately controlled. Lack of access to health services due to multiple types of barriers as wellas the lack of patients' adherence to control and treatment are the main problems that explain this gap. The incorporation and integration of the pharmacists to the health system and the use of Information and Communication Technologies (ICTs) have showed highly promising results in the improvement of the management of this condition; however, they are scarcely used in Argentina. In 2018, the Secretariat of Health of the Municipality of General Pueyrredón, Province of Buenos Aires, prompted an innovatingcommunity-program, which incorporates the pharmacists to the municipal health system as well as a virtual platform ("Health MGP", https://saludmgp.rpmplay.com/) and a mobile app targeted to hypertensive patients. Pharmacists' incorporation will improve patients' access to health services, as most people have a pharmacy near their home and they do not need a scheduled turn to assist. Besides, pharmacists will collaborate in patients' follow-up, through blood pressure, counselling and medication use supervision. Thevirtual platform will permit hypertensive patients to be part of a virtual community, in which other hypertensive patients and health professionals participate and through which, the patient can interact with others and be actively involved in the management of the disease. The mobile app will send reminders to hypertensive patients to support their involvement in the program and reinforce adherence to recommendations. We propose a mixed-study to assess the access, acceptability, adoption and impact of this program,and to use this experience as a case study to promote the debate among key stakeholders of the policy and legal fields about the pharmacists' participation in the health system as well as the use of ICTs in the management of NCDs and hypertension. The incorporation of these technologies not only constitutes the future in the management of Chronic Disease but also represents a shift in the paradigm of care. They contribute to the transformation of the health system from one that is essentially reactive to one that isproactive through the active involvement of the patient in the self-management of their disease.