scholarly journals Evaluation and pilot implementation of essential interventions for the management of hypertension and prevention of cardiovascular diseases in primary health care in the Republic of Tajikistan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dylan Collins ◽  
Laura Inglin ◽  
Tiina Laatikainen ◽  
Mekhri Shoismatuloeva ◽  
Dilorom Sultonova ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
Primary Health Care ◽  
Blood Pressure Control ◽  
Regression Models ◽  
Pressure Control ◽  
Primary Health ◽  
Essential Interventions ◽  
Clinical Records

Abstract Background The aim of this study was to determine the feasibility of implementing and evaluating essential interventions for the management of hypertension and prevention of cardiovascular disease in primary healthcare in Tajikistan. Methods The study protocol was published a priori. A pragmatic, sequential, mixed methods explanatory design was piloted. The quantitative strand is reported here. All primary health care facilities that met inclusion criteria in Shahrinav district were included and computer randomized to either usual care or intervention. The intervention consisted of: adaptation of WHO PEN/HEARTS clinical algorithms for hypertension and diabetes, a two-day training of doctors and nurses, supportive supervision visits, clinical decision support tools, and quality improvement support. Data were collected from paper-based clinical records at baseline and 12 months follow-up. The primary outcome was blood pressure control among patients with hypertension, in addition to several secondary process indicators along the care pathway. Age and sex adjusted logistic regression models were used for intervention and control clinics to determine changes between baseline and follow-up and to assess interactions between allocation group and time. For continuous variables, multivariate linear regression models were used. Results 19 primary health care centres were included of which ten were randomized to intervention and nine to control. 120 clinicians received training. The records of all registered hypertensive patients were reviewed at baseline and follow-up for a total of 1,085 patient records. Blood pressure control significantly improved in the intervention clinics (OR 3.556, 95 % CI 2.219, 5.696) but not the control clinics (OR 0.644, 95 % CI 0.370, 1.121) (p < 0.001 for interaction). Smoking assessment, statin prescribing, triple therapy prescribing, and blood pressure measurement significantly improved in intervention clinics relative to control, whereas cholesterol and glucose testing, and aspirin prescribing did not. Conclusions It is feasible to use routine, paper-based, clinical records to evaluate essential CVD interventions in primary health care in Tajikistan. Adapted WHO PEN/HEARTS guidelines in the context of a complex intervention significantly improved blood pressure control after 12 months.

scholarly journals Treating patients with hypertension in Indonesia’s primary health care centre: A challenging condition

2019 ◽  
Vol 2019 (2) ◽  
Author(s):  
Lucky Aziza Abdullah Bawazir ◽  
Wicensius Sianipar
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
Primary Health Care ◽  
Calcium Channel ◽  
Blood Pressure Control ◽  
Calcium Channel Blockers ◽  
Antihypertensive Agents ◽  
Pressure Control ◽  
Channel Blockers ◽  
Primary Health

Background: In Indonesia, hypertension treatment relies on primary health care services, and there are no current data on blood pressure control and hypertension treatment in Indonesia’s primary health care system.Methods: We conducted a cross-sectional study including all patients with hypertension (n = 273) who visited the Tegal Alur II Community Health Center in 2017. For all patients with hypertension, medical records containing the most recent blood pressure results and antihypertensive treatments were examined by the authors. The primary outcome in this study was optimal blood pressure control according to the Joint National Committee (JNC) VII guidelines.Results: The mean systolic and diastolic blood pressures were 143.7 mmHg (SD 18.5) and 87 mmHg (SD 11.4), respectively. Calcium channel blockers were the most frequently used antihypertensive agents (58.6%). Of all patients with hypertension, 27.1% achieved controlled blood pressure. Bivariate analysis revealed a significant association between antihypertensive agents and blood pressure control (p = 0.009). Multivariate analysis showed that calcium channel blockers were the strongest predictor of blood pressure control, with an adjusted odds ratio of 1.9 (95% confidence interval [CI] 1.1–3.5, p= 0.022).Conclusion: Controlled blood pressure was achieved by less than half of all patients with hypertension visiting the Tegal Alur II Community Health Center in 2017. The majority of patients with hypertension received single-drug therapy with calcium channel blockers, the most frequently used antihypertensive agents. There was a significant association between antihypertensive agents and blood pressure control.Funding: This study received no financial support from any specific funding agencies.

Organization of the therapeutic education process in hypertension at the level of primary health care

2021 ◽  
pp. 52-58
Author(s):  
Alexandra Topa ◽  
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
Primary Health Care ◽  
Blood Pressure Control ◽  
Medical Staff ◽  
Pressure Control ◽  
Therapeutic Education ◽  
Planning Stage ◽  
Education Of Patients ◽  
Primary Health

High blood pressure is a major public health problem, with indicators of morbidity and mortality being alarming. Therapeutic education in hypertension increases the level of awareness, blood pressure control and prevents complications. The aim of the study is to evaluate the process of organizing the therapeutic education of patients with hypertension at the level of primary health care in the Republic of Moldova. Study design: descriptive, transversal, by applying the questionnaire developed in the interest of the study. Study methods: statistical, synthetic, comparative, graphical. Th e study involved 371 respondents, of which 65% family physicians, 35% nurses. The majority of medical staff (98.1%) consider therapeutic education important, 87.3% recognized the definition of therapeutic education and its benefits: blood pressure control (90.6%); decrease in mortality caused by complications (81.7%); increasing treatment compliance (72.5%); disease awareness (65.5%). The surveyed medical staff demonstrated a disproportionate involvement in the 4 stages of the organization process: 42.3% are involved in the planning stage, 93.0% - implementation 29.1% - evaluation and 54.2% - organization. The process of organizing therapeutic education is incomplete, due to the lack or insufficiency of planning and evaluation of therapeutic education of patients with hypertension.

scholarly journals Effectiveness of multidisciplinary intervention on blood pressure control in primary health care: a randomized clinical trial

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Regina Kuhmmer ◽  
Rosmeri Kuhmmer Lazzaretti ◽  
Cátia Moreira Guterres ◽  
Fabiana Viegas Raimundo ◽  
Leni Everson Araújo Leite ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
Clinical Trial ◽  
Primary Health Care ◽  
Randomized Clinical Trial ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Multidisciplinary Intervention ◽  
Primary Health

The impact of routine follow-up with health care teams on blood pressure control among patients with hypertension

2019 ◽  
Vol 33 (6) ◽  
pp. 466-474
Author(s):  
Hui-Juan Zuo ◽  
Ji-Xiang Ma ◽  
Jin-Wen Wang ◽  
Xiao-Rong Chen ◽  
Lei Hou
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Health Care Teams ◽  
The Impact

scholarly journals Cohort study of ageing from Bagé (SIGa-Bagé), Brazil: profile and methodology

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elaine Thumé ◽  
Marciane Kessler ◽  
Karla P. Machado ◽  
Bruno P. Nunes ◽  
Pamela M. Volz ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Cohort Study ◽  
Primary Health Care ◽  
Rio Grande ◽  
Cognitive Testing ◽  
Rio Grande Do Sul ◽  
Primary Health ◽  
The Impact

Abstract Background The Bagé Cohort Study of Ageing is a population-based cohort study that has recently completed the first follow-up of a representative sample of older adults from Bagé, a city with more than 100,000 inhabitants located in the state of Rio Grande do Sul, Brazil. This is one of the first longitudinal studies to assess the impact of primary health care coverage on health conditions and inequalities. Our aim is to investigate the prevalence, incidence and trends of risk factors, health behaviours, social relationships, non-communicable diseases, geriatric diseases and disorders, hospitalisation, self-perceived health, and all-cause and specific-cause mortality. In addition, we aim to evaluate socioeconomic and health inequalities and the impact of primary health care on the outcomes under study. Methods/design The study covers participants aged 60 or over, selected by probabilistic (representative) sampling of the urban area of the city of Bagé, which is covered by Primary Health Care Services. The baseline examination included 1593 older adults and was conducted from July 2008 to November 2008. After eight to nine years (2016/2017), the first follow-up was conducted from September 2016 to August 2017. All participants underwent an extensive core assessment programme including structured interviews, questionnaires, cognitive testing (baseline and follow-up), physical examinations and anthropometric measurements (follow-up). Results Of the original participants, 1395 (87.6%) were located for follow-up: 757 elderly individuals (47.5%) were re-interviewed, but losses in data transfer occurred for 22. The remaining 638 (40.1%) had died. In addition, we had 81 (5.1%) refusals and 117 (7.3%) losses. Among the 1373 older adults who were followed down, there was a higher proportion of female interviewees (p=0.042) and a higher proportion of male deaths (p=0.001) in 2016/2017. There were no differences in losses and refusals according to gender (p=0.102). There was a difference in average age between the interviewees (68.8 years; SD ±6.5) and non-interviewees (73.2 years; SD ±9.0) (p<0.001). Data are available at the Department of Social Medicine in Federal University of Pelotas, Rio Grande do Sul, Brazil, for any collaboration.

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