ROLE OF CARDIOLOGY CLINICAL PHARMACY SPECIALIST AND TELEMEDICINE IN THE DIAGNOSIS AND MANAGEMENT OF HYPERTENSION IN PATIENTS WITH CANCER AT THE CARDIO-ONCOLOGY CLINIC

Objective: To identify the role of cardiology clinical pharmacy specialist and telemedicine in the management of hypertension in patients with cancer. Design and method: A prospective observational study was conducted at the cardio-oncology clinic in Baghdad, Iraq between November 2021 to February 2023. The clinic is one day/week. Cardiology clinical pharmacy specialist is among the heart team members at the clinic, she was responsible for offering patients optional communication using telemedicine by sending their home blood pressure (HBP) measurement whether patients have hypertension (HTN) or not (for primary prevention). Patients were educated about the correct way to measure and record HBP. At least BP sent for 3 days. In case of elevated HBP, the cardiology pharmacist makes a decision in collaboration with the cardiologist to optimize treatment. Positive response to treatment is defined as reducing BP to value <140/90 mmHg during cancer therapy. Elevated BP is confirmed based on at least two readings. Results: There were 35 patients enrolled in the study, mean age 55±9 years. Breast cancer was the most common type of cancer 27 (77%) followed by gastrointestinal 4 (11%), and 24 (69%) of patients were known to have HTN. Elevated BP were recorded in 20 (57%) patients including the 3 (9%) newly diagnosed patients. For patients with elevated BP the mean systolic BP was 150±11 mmHg and for diastolic BP was 95±7 mmHg. Interventions by the cardiology pharmacist included the following: confirmation of elevated BP (diagnosis) and optimization of anti-hypertensive therapy in collaboration with the cardiologists (optimized therapy). Some patients lost follow-up (FU) or returned to their general physicians after the diagnosis of elevated BP for management, results are shown in Figure 1.Conclusions: More than one-half of the patients with cancer in this study had uncontrolled BP which was diagnosed by a cardiology clinical pharmacy specialist using telemedicine. About one-half of the latter patients were managed in collaboration between the cardiology pharmacist and the cardiologist. Role of a specialized cardiology pharmacist at the cardio-oncology clinic can be one of the keys for better management and control of HTN.