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

高血压是阿根廷心血管疾病的主要危险因素之一，也是导致大量疾病和死亡的原因。尽管有关于有效治疗和预防策略的广泛知识，但有一个差距限制了将这些知识转化为患者的好处，特别是对贫穷患者的好处。几乎一半的高血压患者不知道自己的病情，大多数人没有得到适当的控制。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是造成这一差距的主要问题。将药剂师纳入和整合到卫生系统以及信息和通信技术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，布宜诺斯艾利斯省普伊尔雷德翁市卫生秘书处推动了一项创新的社区计划，将药剂师纳入市卫生系统，并建立了一个虚拟平台(“Health MGP”、https://saludmgp.rpmplay.com/)和一个针对高血压患者的移动应用程序)。药剂师的成立将改善患者获得医疗服务的机会，因为大多数人在家附近都有药房，他们不需要预定的轮流来帮助他们。此外，药剂师将通过血压、咨询和用药监督合作对患者进行随访。这个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参与其中，通过这个社区，患者可以与其他人互动，积极参与疾病的管理。这款手机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。我们建议进行一项混合研究，以评估这一计划的可及性、可接受性、采用率和影响，并将这一经验作为案例研究，以促进政策和法律领域的关键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和通信技术的辩论。纳入这些技术不仅构成了慢性病管理的未来，而且也代表了护理模式的转变。它们有助于将卫生系统从基本上是反应性的转变为通过患者积极参与其疾病的自我管理而积极主动的转变。

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.