On Community Pharmacists and Promotion of Lifestyle Modification in Adults with Hypertension

Practice Protocol


  • Dr. Olanike Kehinde Walden University, Minneapolis, USA https://orcid.org/0000-0002-6090-789X
  • Dr. Kimberly Dixon-Lawson Faculty member, School of Health Sciences, Walden University, USA
  • Dr. Aaron Mendelsohn Snr. Adjunct faculty, Faculty of Public Health, Walden University USA




Hypertension, practice protocol, promotion of lifestyle modification, community pharmacists, phenomenology



The growing prevalence of hypertension is a problem of public health importance globally. Lifestyle modification is an important first-step in the management of hypertension requiring promotion by all healthcare professionals. However there is not enough focus on the contribution of pharmacists towards promotion of lifestyle modification (PLM) in the management of hypertension in Nigeria.


A phenomenological study involving in-depth interviews of 12 community pharmacists was conducted to explore how community pharmacists promote lifestyle modification in adults with hypertension Lagos, Nigeria and to develop a practice protocol for community pharmacists for guiding the practice of PLM. Participants were purposively selected as key knowledgeables who could give rich and nuanced insights about the phenomenon of PLM and an interview protocol was used to guide the interviews.


From a thematic data analysis conducted, 7 themes emerged to categorize the practice of PLM by community pharmacists among hypertensive adults and the essence of a practice protocol. The themes pertaining to practice were cognitive factors, contextual factors, strategies, and self efficacy. From the perspectives of the participants, a practice protocol was developed that can serve as a guide to community pharmacists in Lagos while performing the role of PLM among adults with hypertension.


Community pharmacists are well positioned in communities to contribute to reducing the incidence and prevalence of hypertension in Nigeria. The availability of a practice protocol will enhance the performance of community pharmacists while promoting lifestyle modification and can help to standardize the practice of PLM.

Key words: Hypertension, practice protocol, promotion of lifestyle modification, community pharmacists, phenomenology

Author Biographies

Dr. Olanike Kehinde, Walden University, Minneapolis, USA

Public health pharmacist

Consultant, Fedunique Nig. Ltd.

Dr. Kimberly Dixon-Lawson, Faculty member, School of Health Sciences, Walden University, USA

Senior  faculty, Faculty of public health, School of Health Sciences, Walden University


Adeloye, D., Basquill, C., Aderemi, A., Thompson, J. Y., & Obi, F. A. (2015). An estimate of the prevalence of hypertension in Nigeria: A systematic review and meta-analysis. Journal of Hypertension, 33(2), 230-242. doi:10.1097/HJH.0000000000000413

Agomo, C., Arit Udoh, A., Kpokiri, E., & Osuku-Opio, J. (2018). Community pharmacists’ contribution to public health: Assessing the global evidence base. Clinical Pharmacist, 10(4). doi:10.1211/CP.2018.20204556

Ajayi, I. O., Soyannwo, M. A. O., Asinobi, A. O., Afolabi, N. B., Ayede, A. I., & Bamgboye, E. A. (2017). Blood pressure pattern and hypertension related risk factors in an urban community in Southwest Nigeria: The Mokola hypertension initiative project, Ibadan, Nigeria. Journal of Public Health and Epidemiology, 9(4), 51-64. doi:10.5897/JPHE2017.0908

Akinlua, J. T., Meakin, R., Aminu, M. U., & Freemantle, N. (2015). Current prevalence pattern of hypertension in Nigeria: A systematic review. PLoS One, 10(10), e0140021 doi:10.1371/journal.pone.0140021

Akinlua, J. T., Meakin, R., Fadahunsi, P., & Freemantle, N. (2015). Beliefs of health care providers, lay health care providers and lay persons in Nigeria regarding hypertension. A systematic mixed studies review. PLoS one, 11(5), e0154287. doi:10.1371/journal.pone.0154287

Alonso-Perales, M. del M., Lasheras, B., Beitia, G., Beltrán, I., Marcos, B., & Núñez-Córdoba, J. M. (2017). Barriers to promote cardiovascular health in community pharmacies: a systematic review. Health Promotion International, 32(3), 535-548. doi:10.1093/heapro/dav098

Bajorek, B. V., LeMay, K. S., Magin, P. J., Roberts, C., Krass, I., & Armour, C. L. (2017). Management of hypertension in an Australian community pharmacy setting-patients’ beliefs and perspectives. International Journal of Pharmacy Practice, 25, 263-273. doi:10.1111/ijpp.12301

Burke, L. E., Ma, J., Azar, K. M., Bennett, G. G., Peterson, E. D., Zheng, Y., . . . Turan, T. N. (2015). Current science on consumer use of mobile health for cardiovascular disease prevention: A scientific statement from the American Heart Association. Circulation, 132(12), 1157-1213. doi:10.1161/CIR.000000000000023

Castleberry, A., & Nolen, A. (2018). Thematic analysis of qualitative research data: Is it as easy as it sounds? Currents in Pharmacy Teaching and Learning, 10(6), 807-815. doi:10.1016/j.cptl.2018.03.019

Challa, H. J., Ameer, M. A., & Uppaluri, K. R. (2021). DASH diet to stop hypertension. In StatPearls [Internet]. StatPearls Publishing..Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK482514/

Chi, P.C., Bulage, P., Urdal, H. & Sundby, J. (2015). A qualitative study exploring the determinants of maternal health service uptake in post-conflict Burundi and Northern Uganda. BMC Pregnancy Childbirth 15, 18-31. doi:10.1186/s12884-015-0449-8

Crittenden, D., Seibenhener, S., & Hamilton, B. (2017). Health coaching and the management of hypertension. The Journal for Nurse Practitioners, 13(5), e237-e239. doi:10.1016/j.nurpra.2017.02.010

Dineen-Griffin, S., Garcia-Cardenas, V., Rogers, K., Williams, K., & Benrimoj, S. I. (2019). Evaluation of a collaborative protocolized approach by community pharmacists and general medical practitioners for an Australian minor ailments scheme: protocol for a cluster randomized controlled trial. JMIR research protocols, 8(8), e13973. doi: 10.2196/13973

Falase, A. O., Aje, A., & Ogah, O. S. (2015). Management of hypertension in Nigerians: Ad hoc or rational basis? Nigerian Journal of Cardiology, 12(2), 158-164. doi:10.4103/0189-7969.161791

Franklin, B. A., Myers, J., & Kokkinos, P. (2020). Importance of lifestyle modification on cardiovascular risk reduction: counseling strategies to maximize patient outcomes. Journal of cardiopulmonary rehabilitation and prevention, 40(3), 138-143. doi: 10.1097/HCR.0000000000000496

Gabarron, E., Bradway, M., Fernandez-Luque, L., Chomutare, T., Hansen, A. H., Wynn, R., & Årsand, E. (2018). Social media for health promotion in diabetes: study protocol for a participatory public health intervention design. BMC Health Services Research, 18(1), 414-418. doi:10.1186/s12913-018-3178-7

Giroir B. P., & Wright, D. (2018). Physical activity guidelines for health and prosperity in the United States. Journal of American Medical Association; 320(19),1971-1972. doi:10.1001/jama.2018.16998

Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.). (2015). Health behavior and health education: Theory, research, and practice (5th ed.). San Francisco, CA: Jossey-Bass

Ikhile, I. J. & Chijioke-Nwauche, I. N. (2016). Pharmacy education in Nigeria: The progression. World Journal of Pharmaceutical Research, 5(7), 258-272. doi: 10.20959/wjpr20167-6507

Isetts, B. J., Buffington, D. E., Carter, B. L., Smith, M., Polgreen, L. A., & James, P. A. (2016). Evaluation of pharmacists’ work in a physician‐pharmacist collaborative model for the management of hypertension. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 36(4), 374-384. doi:10.1002/phar.1727

Joseph, R. P., Daniel, C. L., Thind, H., Benitez, T. J., & Pekmezi, D. (2016). Applying psychological theories to promote long-term maintenance of health behaviors. American Journal of Lifestyle Medicine, 10(6), 356-368. doi:10.1177/1559827614554594

Kehinde, O. O., Dixon-Lawson, K. G., & Mendelsohn, A. B. (2020) Social cognitive theory and perspectives of community pharmacists about promotion of lifestyle modification in hypertensive adults. International Journal of Public Health and Epidemiology, 9(7), 001-011. doi.org/10.46882/IJPHE/1211

Laliberté, M., Perreault, S., Damestoy, N., & Lalonde, L. (2012). Ideal and actual involvement of community pharmacists in health promotion and prevention: A cross-sectional study in Quebec, Canada. BMC Public Health, 12, 192. doi:10.1186/1471-2458-12-192

Lloyd Williams, D. (2022). On Healthcare Research Priorities in the USA : From Long COVID to Precision Health, what else is new?. International Healthcare Review (online), 1(1). https://doi.org/10.56226/ihr.v1i1.14

Maes, K. A., Studer, H., Berger, J., Hersberger, K. E., & Lampert, M. L. (2017). Documentation of pharmaceutical care: Validation of an intervention oriented classification system. Journal of Evaluation in Clinical Practice, 23(6), 1425-1432. doi:10.1111/jep.12817

Marfo, A. F. & Owusu-Daaku, F. T. (2017). Exploring the extended role of the community pharmacist in improving blood pressure control among hypertensive patients in a developing setting. Journal of Pharmaceutical Policy and Practice, 10, 39-47. doi:10.1186/s40545-017-0127-5

Monachino, M. . (2022). On Healthcare Research for Disease Prevention: Critical Knowledge Gaps in European Public Health. International Healthcare Review (online), 1(1). https://doi.org/10.56226/ihr.v1i1.6

Moreira, P. (2022). On New Clinical Research Methods and Technologies: From decentralised designs to Artificial Intelligence. International Healthcare Review (online), 1(1). https://doi.org/10.56226/ihr.v1i1.11

Pius, E. A., Iheanyichukwu, W., Adebayo, O. G., Chibuzor, N. A., & Kelechi, M. S. (2021). Sociodemographic Factors Associated with chronic Diseases in an Urban Community of Rivers State in Nigeria. Journal of Pathology and Toxicology Research, 2(1), 36-43.

Saramunee, K., Krska, J., Mackridge, A., Richards, J., Suttajit, S., & Phillips-Howard, P. (2014). How to enhance public health service utilization in community pharmacy: General public and health providers’ perspectives. Research in Social and Administrative Pharmacy, 10(2), 272-284. doi:10.1016/j.sapharm.2012.05.006

World Health Organization (2021). Noncommunicable diseases. Geneva, Switzerland: Author. Retrieved from https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases.

community pharmacy hypertension service


12-01-2023 — Updated on 16-01-2023

How to Cite

Kehinde, O., Dixon-Lawson, K., & Mendelsohn, A. (2023). On Community Pharmacists and Promotion of Lifestyle Modification in Adults with Hypertension: Practice Protocol. International Healthcare Review (online). https://doi.org/10.56226/49



Recent Articles