Dr. Likhitha Tadituri on Patient-Centered Pharmacy Care and Hypertension Awareness (Part-2)

Dr. Likhitha Tadituri: After receiving the prescription, and sometimes even after the medication has been dispensed, there can be a final consultation with the clinical pharmacist. Once the doctor finishes prescribing, most hospitals have a clinical pharmacy department where the patient is directed.

The staff will usually say, “You can purchase the medications and come back, and we’ll explain everything clearly.” If there are fixed-dose combinations, the pharmacist will explain how to take them. They may also recommend pill boxes to help the patient organize their medication according to color or timing.

They provide a clear explanation about the purpose of each pill, the correct time to take it, and what may happen if doses are missed. Clinical pharmacists are qualified to answer medication-related queries, making this an ideal point of contact for patients.

Dr. Likhitha Tadituri: Not in every government hospital, but I have seen them in a few. That’s one reason for the scarcity of clinical pharmacy jobs. Despite its importance, the role of clinical pharmacists lacks proper recognition from the government in India. Unfortunately, both clinical pharmacy and the PharmD program are still not well acknowledged.

Dr. Likhitha Tadituri: That’s common. Every healthcare professional has faced such situations. Patients can be difficult. Doctors often encounter patients who Google everything before the consultation and then ask countless questions, sometimes testing the doctor’s patience.

Nurses face it too—especially with inpatients—when patients demand more than just medication administration. This is part of the job across all departments. So don’t worry; you’re not alone.

Dr. Likhitha Tadituri: The first and most important step is proper counseling. Unless a patient is willing to take their medications, we can't monitor them 24/7, especially if they’re not hospitalized.

We need to provide clear counseling: why they’re taking a medication, what happens if they miss a dose, and how to deal with side effects or allergies. Reassurance is key—letting them know the treatment is safe and that they’re in good hands.

Secondly, we can reduce polypharmacy. When patients see too many pills, they get overwhelmed. Even if we write instructions clearly, once they start pulling pills out, the order can become confusing.

That’s why we recommend using pill boxes with compartments. Medications are arranged by time and color—say, box one for the morning dose. Visual aids help patients remember better than verbal instructions alone. This significantly improves adherence.

Dr. Likhitha Tadituri: It’s straightforward. Hypertension is a silent killer, and morning hypertension is especially dangerous because it’s linked to a higher risk of cardiovascular events.

Why? Because the body is at rest for 7–8 hours, and when we suddenly wake up and begin physical activity, there’s a natural surge in blood pressure. For someone already hypertensive, this can be risky, leading to strokes or other complications.

That’s why we recommend home blood pressure monitoring, especially in the morning. Patients should check their BP three times a day, and if anything seems abnormal, they should contact their doctor, nurse, or pharmacist immediately. Morning readings are crucial.

Dr. Likhitha Tadituri: As I mentioned earlier, hypertension is a silent killer. It doesn’t have clear-cut symptoms. However, based on clinical observations and research, fatigue is a major but overlooked sign.

Patients often feel weak, confused, or forgetful. They might ask themselves, “Did I do that?” or “Did I say that?” These memory lapses are commonly dismissed as stress or psychiatric issues, but they can be early indicators of hypertension.

Dr. Likhitha Tadituri: It’s the lifestyle—plain and simple. The Gen Z lifestyle is being adopted even by people in their forties now. Previous generations had healthier habits and ate nutritious food.

Today, junk food is introduced at a very young age, making younger individuals more prone to hypertension compared to earlier generations. Lifestyle is the key factor.

Dr. Likhitha Tadituri: If a patient smokes or consumes alcohol, the first step is to quit. Monitoring salt intake is also critical. Maintaining a low-sodium diet can help regulate blood pressure levels effectively.

Dr. Likhitha Tadituri: Regarding hypertension — like I said, it’s a silent killer. It usually doesn’t show any signs or symptoms. I would strongly suggest that everyone get their blood pressure checked regularly and maintain proper lifestyle habits by avoiding junk food. Even excessive intake of oil and salt can easily trigger hypertension. If it’s genetic, we may not be able to prevent it entirely, but since it doesn’t present obvious symptoms, I highly recommend regular monitoring and adopting a healthy lifestyle. No alcohol, no smoking — that’s the best way to prevent hypertension.

Dr. Likhitha Tadituri: Yes, they are reliable. In fact, even in tertiary care hospitals, digital blood pressure monitors are replacing traditional sphygmomanometers. As the demand increases, so does the accuracy and availability.

Just like how thermometers became common after COVID, digital BP monitors have become more accessible because of the increased awareness of cardiovascular risks. These devices are accurate, affordable, and easy to use.

Not everyone is trained to use a sphygmomanometer. Unless someone is a doctor, nurse, or PharmD graduate, they likely won’t use it correctly. Most people don’t have a stethoscope or know how to read mercury levels, so digital monitors are a great home option.

Dr. Likhitha Tadituri: If a person is already hypertensive, yes, they should check it daily. If not, checking once a week or during periods of extreme stress or noticeable symptoms like a rapid heartbeat is sufficient.

Technology has advanced so much that even a smartwatch can track blood pressure. You don’t always need a separate device now. That makes it even easier to stay on top of your health.

Dr. Likhitha Tadituri: Pharmacists play a crucial role in preventing this. They are the ones with the knowledge to understand which drugs are over-the-counter (OTC) and which require a prescription.

Hypertensive medications are not OTC drugs. They are high-risk and should never be given without a valid prescription. It is the pharmacist’s responsibility to stop dispensing such drugs without one.

Public awareness is also important. People need to know that just because a medicine worked for someone else doesn’t mean it is safe for them. Medication needs to be tailored to the individual’s health condition, which only a doctor can assess.

The pharmacist is the checkpoint. If a medicine is reaching the patient, it’s going through the pharmacist. So, education must start from there.

Pharmacists must explain to patients: “You cannot take this medication without consulting a doctor. The correct drug and dosage depend on your individual condition.” For example, even with a cough, is it dry or wet? Is it an upper or lower respiratory infection? Each scenario requires a different approach.

That’s why proper diagnosis is essential. Only OTC drugs should be dispensed without a prescription — and even that is based on a fixed, approved list.

Dr. Likhitha Tadituri: As a clinical pharmacist, I’ve seen many cases where even after prescribing the correct medication and dosage, patients still experienced life-threatening events — like in my father’s case. He was already taking antihypertensive drugs, but he still had a major health crisis.

So just imagine the risk for someone who hasn’t even consulted a doctor and is self-medicating. Hypertension isn’t a minor issue. It’s a leading cause of severe health conditions, including strokes that can happen within minutes, leaving no time for medical intervention.

This isn’t like treating a cold where you can guess what might work. You can't just walk into a pharmacy and take the same medicine your relative takes, thinking your genes are similar. It doesn’t work like that.

For conditions like hypertension, a doctor’s consultation is crucial. Only then can the right treatment be selected. That’s all I would like to say.