13 OPPORTUNITIES TO IMPROVE HYPERTENSION CARE IN THE COMMUNITY
Bibliographic record
Abstract
Public-use blood pressure (BP) kiosks are present in most community pharmacies and are frequently used, yet their role in patient care is not defined. Objective: To determine the distribution of BP measurements obtained at BP kiosks in community pharmacies in Canada to determine the proportion of users who may benefit from intervention. Methods: BP results were obtained from 341 PharmaSmart PS-2000 kiosks from January 2010 – November 2011 from casual users and those enrolled in the SmartCard program (which uses an electronic card to track individual patient BP results). Readings were classified as optimal (<130/80 mmHg), pre-hypertensive (130-139/80-89), uncontrolled (140-159/90-109) or very high (≥160/110). When systolic and diastolic BP fell into different classifications, the higher of the two was applied. Results: Of 8,457,552 casual readings analyzed, mean BP was 131/78 (SD 13.7/13.4) mmHg with mean pulse of 76 beats/minute (SD 5.6). Of these, 37% of measurements were optimal, 27% pre-hypertensive, 29% uncontrolled, and 7% very high. Results from casual users did not differ significantly from SmartCard users. Correlation between heart rate and BP was weak except for diastolic BP among SmartCard users (R2 = 0.77), suggesting that insufficient rest before measurement is unlikely to be responsible for elevated results in most cases. Conclusions: Pharmacy-based BP kiosks are used frequently by the public, and two-thirds of readings obtained are elevated. This is an untapped opportunity for pharmacists to become involved in the detection of uncontrolled hypertension and provide education, care and referrals to patients with the goal of reducing their risk of cardiovascular events.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.004 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.047 | 0.005 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".