Pharmacists’ Roles in Hypertension Management within Indonesian Community-Based Elderly Health Services: A qualitative study

Abstract

Objective: This study explores hypertension management within Indonesian Posyandu Lansia (Elderly Integrated Health Posts). It aims to identify treatment practices, medication adherence, implementation barriers, and pharmacists’ roles to inform health service management and policy development for aged care.

Design: An observational qualitative study was carried out using a phenomenological approach. The data were gathered through semi-structured interviews with a total of 32 participants, including 14 elderly patients, 12 community cadres, and 6 healthcare professionals. The collected narrative data were analyzed using an inductive thematic analysis to identify essential patterns and phenomena.

Setting: The research was carried out at the Banguntapan II and Piyungan Puskesmas (Community Health Centers) and their affiliated Posyandu Lansia in Bantul Regency, Indonesia.

Main outcome measures: Qualitative themes were identified regarding the implementation of hypertension treatment, medication adherence patterns, operational management barriers (e.g., funding and administration), and the integration of pharmacists into community-based settings.

Result: Posyandu activities primarily focus on routine monitoring and social engagement, yet medication adherence remains low as many elderly patients only take medication when symptomatic. Critical management barriers include restricted village funding and heavy administrative burdens. Regarding the pharmacist's role, their involvement is primarily promotive and preventive, focusing on drug information education, counseling, medication safety monitoring, and stock control. However, these roles are not yet optimized because health center management prioritizes in-facility pharmaceutical services over community outreach.

Conclusion: Effective hypertension management in community settings is hindered by operational and policy-related constraints. Pharmacists play an essential role in bridging education gaps and ensuring medication safety, yet their direct involvement remains limited. The practical implications of these findings suggest that strengthening interprofessional collaboration and revising policies to support direct pharmacist participation are vital for optimizing public health programs and improving clinical outcomes for the elderly population.