***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The effect of pharmaceutical care on the prevention , detection , and resolution of medication-related problems in high-risk patients in a rural community was studied . Adult patients who received care at clinics in a medically underserved area of Alabama and who were identified as being at high risk of medication-related adverse events were r and omly assigned to a control group or an intervention group . The control group received st and ard medical care , and the intervention group received pharmaceutical care , including a medical record review , a medication history review , pharmacotherapeutic evaluation , and patient medication education and monitoring over a one-year period .  A total of 69 patients completed the study ( 33 in the intervention group and 36 in the control group ) . The percentage of patients responding to hypertension , diabetes , dyslipidemia , and anticoagulation therapy increased significantly in the intervention group and declined in the control group . Ratings for inappropriate prescribing improved in all 10 domains evaluated in the intervention group but worsened in 5 domains in the control group . There were no significant differences between the groups at 12 months in health-related quality of life or medication misadventures . Medication compliance scores improved in the intervention group but not in the control group . Medication knowledge increased in the intervention group and decreased in the control group . Pharmaceutical care in a rural , community-based setting appeared to reduce inappropriate prescribing , enhance disease management , and improve medication compliance and knowledge without adversely affecting health-related quality of life Address correspondence to : L.D. Saunders , Department of Health Services Administration and Community Medicine , 13 - 103 Clinical Sciences Building , University of Alberta , Edmonton , Alberta Canada T6 G 2G3 among patients attending a primary health care ( PHC ) clinic in Soweto for antihypertensive drug therapy .  In a 1-year follow-up study of an inception cohort of newly treated hypertensives , only 27 % were compliant ( defined as attending frequently enough to receive 80 % or more of their required treatment ) , 42 % were not seen after the first 3 months ( early dropouts ) , and 22 % continued to attend until the last 3 BACKGROUND St and ard office-based approaches to controlling hypertension show limited success . Such suboptimal hypertension control reflects in part the absence of both an infrastructure for patient education and frequent , regular blood pressure ( BP ) monitoring . We tested the efficacy of a physician-directed , nurse-managed , home-based system for hypertension management with st and ardized algorithms to modulate drug therapy , based on patients ' reports of home BP . METHODS We r and omized out patients requiring drug therapy for hypertension according to the Joint National Committee on Prevention , Detection , Evaluation , and Treatment of High Blood Pressure ( JNC VI ) criteria to receive usual medical care only ( UC , n = 76 ) or usual care plus nurse care management intervention ( INT , n = 74 ) over a 6-month period . RESULTS Patients receiving INT achieved greater reductions in office BP values at 6 months than those receiving UC : 14.2 + /- 18.1 versus 5.7 + /- 18.7 mm Hg systolic ( P < .01 ) and 6.5 + /- 10.0 versus 3.4 + /- 7.9 mm Hg diastolic , respectively ( P < .05 ) . At 6 months , we observed one or more changes in drug therapy in 97 % of INT patients versus 43 % of UC patients , and 70 % of INT patients received two or more drugs versus 46 % of UC . Average daily adherence to medication , measured by electronic drug event monitors , was superior among INT subjects ( mean + /- SD , 80.5 % + /- 23.0 % ) than among UC subjects ( 69.2 + /- 31.1 % ; t(113 ) = 2.199 , P = .03 ) . There were no significant adverse drug reactions in either group . CONCLUSIONS Telephone-mediated nurse management can successfully address many of the systems-related and patient-related issues that limit pharmacotherapeutic effectiveness for hypertension OBJECTIVE To evaluate the effect of a 9-month community pharmacy-based medication therapy management ( MTM ) program on quality of care in patients with diabetes and hypertension . DESIGN R and omized controlled trial . SETTING Tulsa , OK , between November 2005 and July 2007 . PATIENTS 52 patients with diabetes and hypertension who were enrolled in a managed care organization . INTERVENTION During monthly visits , intervention group participants received MTM services for hypertension and diabetes management . MAIN OUTCOME MEASURES Systolic blood pressure ( SBP ) , percentage at goal blood pressure ( < 130/80 mm Hg ) , and antihypertensive medication adherence . RESULTS The mean intervention group SBP decreased 17.32 mm Hg , whereas the mean control group SBP level increased 2.73 mm Hg ( P = 0.003 ) . The percentage of patients at goal blood pressure increased from 16.0 % to 48.0 % in the intervention group and decreased from 20.0 % to 6.67 % in the control group . Intervention group participants were 12.92 times more likely than control group participants to achieve goal blood pressure ( P = 0.021 ) . Although the mean adherence rate in the intervention group increased 7.0 % while remaining fairly constant in the control group ( -0.7 % ) , this group difference was not statistically significant . CONCLUSION A community pharmacy-based hypertension MTM program was effective in improving blood pressure control among managed care enrollees with diabetes and hypertension . Community pharmacists are strategically positioned to provide MTM services and effectively communicate with providers to improve quality of care for patients To assess the value of improved monitoring of medication‐taking behavior in a drug trial , we employed a modified pill vial with microcircuitry to record the precise times when the vials were opened . After a 3‐week placebo washout period , 21 ambulatory subjects with mild hypertension ( mean age , 57 years ; 67 % men ; 76 % white ) r and omly received isradipine or enalapril twice daily in a double‐blind titration during 10 weeks . Both drugs achieved a 13 % reduction in sitting diastolic blood pressure ( p < 0.01 ) with minimal symptomatic or laboratory toxicity . Although pill counts indicated near‐perfect compliance ( 92 % to 99 % for both groups ) , the electronic monitor showed that fewer than half of all openings occurred at the prescribed interval of 12 ± 2 hours . Modest overdispensing was documented in the 3 days before scheduled visits . The monitor confirmed that pill count misclassified compliance sufficiency in 22 % of visits and permitted more discrete attribution for drug‐associated adverse reactions and secondary resistance to treatment . We conclude that the electronic monitor reduces ambiguity about medication compliance and helps interpret both the biology and pharmacology of the trial AIM The aim of this paper is to describe the prevalence of cardiovascular risk factors in families screened systematic ally by nurses in British general practice , and in subgroups with reported hypertension , hypercholesterolaemia , diabetes and coronary heart disease . METHOD Twenty six general practice s ( 13 intervention and 13 control practice s ) in 13 towns in Engl and , Wales and Scotl and were involved in a r and omized control trial . R and omly ordered invitations were sent for a family health check to 4158 households ( men aged 40 - 59 years and their partners ) registered with the 13 intervention practice s. RESULTS One or more adult members from 2373 households ( 57 % ) were screened ; in 1477 visits the selected man and his female partner attended of whom 98 % were married . In all , 3850 individuals were screened ( 2246 men and 1604 women ) ; 15 % of men and women were in the predefined top quintile of the British family heart study risk score . Twenty four per cent of men and 22 % of women smoked cigarettes and 62 % of men and 44 % of women were overweight ( body mass index 25 + ) . One third of men and one sixth of women with no known history of high blood pressure had a diastolic blood pressure of 90 + mmHg . Among the 491 individuals with previously reported high blood pressure 64 % were not adequately controlled , having a diastolic blood pressure of 90 + mmHg , while 26 % had diastolic blood pressure of 100 + mmHg . Eighteen per cent of men and women with no known history of a high cholesterol level had a r and om cholesterol level of 6.5 + mmol l-1 . In the 173 people with a previously reported high cholesterol level  and who had their level measured over half had a cholesterol level of 6.5 + mmol l-1 and in 7 % this level was 8.0 + mmol l-1 . One per cent of men and 0.3 % of women were newly identified as diabetic ( r and om glucose level of 10.0 + mmol l-1 ) . In the 52 with previously diagnosed diabetes unsatisfactory control was found in 52 % ( r and om level of 10.0 + mmol l-1 ) . A total of 3034 men and women overall ( 79 % ) qualified for follow up for one or more risk factor ; 1909 men ( 85 % ) and 1125 women ( 70 % ) . Among the 139 with pre-existing coronary heart disease 119 ( 86 % ) had modifiable risk factors : 27 % were cigarette smokers , 68 % had a body mass index of 25 + , 40 % had diastolic hypertension , 29 % had hypercholesterolaemia and 19 % had hyperglycaemia . Five per cent of men and women were taking antihypertensive drugs , 0.3 % cholesterol lowering drugs and 0.7 % drugs for diabetes . CONCLUSION There is considerable scope for primary and secondary prevention among families registered with general practice s , but whether nursing and medical intervention can reduce the risk factors related to cardiovascular disease in this setting remains unknown OBJECTIVE To analyze the effect of an intervention to provide information with mobile phone text messages to patients with hypertension on compliance with therapy for hypertension . DESIGN Comparative , controlled , multicenter , r and omized cluster study . SETTING 26 primary care health centers in Spain . PARTICIPANTS 26 research ers were r and omized to a control group or an intervention group ( 52 patients each , for a total of 104 patients ) . All patients were receiving monotherapy for uncontrolled hypertension . INTERVENTION Patients in the control group received their physician 's usual interventions . Patients in the intervention group received messages and reminders sent to their mobile phones 2 days per week during 4 months . MAIN OUTCOME MEASURES Tablets were counted and blood pressure was measured at the start of the study and 1 , 3 , and 6 months later . The percentage of compliers , mean percentage of compliance and degree of control of hypertension were compared . The reduction in absolute and relative risk was calculated , as was the number of individuals needed to treat to avoid noncompliance . RESULTS The results were evaluated for a total of 67 individuals ( 34 in the intervention group and 33 in the control group ) . The rate of compliance was 85.1 % ( CI , 74.9%-95.3 % ) overall , 85.7 % ( CI , 70.5%-100.9 % ) in the control group and 84.4 % in the intervention group ( CI , 70.7%-95.3 % ) ( P = NS ) . Mean percentage compliance was 90.2%+/-16.3 % overall , 88.1%+/-20.8 % in the control group and 91.9%+/-11.6 % in the intervention group ( P = NS ) . The percentage of patients whose hypertension was controlled at the end of the study was 51.5 % ( CI , 34.4%-68.6 % ) in the control group and 64.7 % ( CI , 48.6%-80.8 % ) in the intervention group ( P = NS ) . CONCLUSIONS The telephone messaging intervention with alerts and reminders sent to mobile phones did not improve compliance with therapy in patients with hypertension BACKGROUND Studies have demonstrated that blood pressure ( BP ) control can be improved when clinical pharmacists assist with patient management . The objective of this study was to evaluate if a physician and pharmacist collaborative model in community-based medical offices could improve BP control . METHODS This was a prospect i ve , cluster r and omized , controlled clinical trial with clinics r and omized to a control group ( n = 3 ) or to an intervention group ( n = 3 ) . The study enrolled 402 patients ( mean age , 58.3 years ) with uncontrolled hypertension .  Clinical pharmacists made drug therapy recommendations to physicians based on national guidelines . Research nurses performed BP measurements and 24-hour BP monitoring . RESULTS The mean ( SD ) guideline adherence scores increased from 49.4 ( 19.3 ) at baseline to 53.4 ( 18.1 ) at 6 months ( 8.1 % increase ) in the control group and from 40.4 ( 22.6 ) at baseline to 62.8 ( 13.5 ) at 6 months ( 55.4 % increase ) in the intervention group ( P = .09 for adjusted between-group comparison ) . The mean B 
    Output:
    
DISCUSSION / CONCLUSIONS Interventions aim ed at improving patients ' knowledge of medications possess the greatest potential clinical value in improving adherence with antihypertensive therapy .