scholarly journals Implementation of a Resistant Hypertension Control Program in a Low-income Primary Care Setting in a High-Income Country: Lessons Learned and Global Applicability

2021 ◽  
Vol 7 (1) ◽  
pp. 19-26
Author(s):  
Elizabeth W. Edwards ◽  
Gabrielle Rhinehart ◽  
Emily Ridley ◽  
Cheryl W. Chandler ◽  
Cynthia Garrick ◽  
...  
Keyword(s):  
Primary Care ◽  
Low Income ◽  
Resistant Hypertension ◽  
Care Setting ◽  
Primary Care Setting ◽  
Control Program ◽  
Lessons Learned ◽  
Income Country ◽  
High Income Country ◽  
Hypertension Control

scholarly journals Resistant Hypertension and Obstructive Sleep Apnea in the Primary-Care Setting

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
M. Demede ◽  
A. Pandey ◽  
F. Zizi ◽  
R. Bachmann ◽  
M. Donat ◽  
...  
Keyword(s):  
Primary Care ◽  
Metabolic Syndrome ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Resistant Hypertension ◽  
Evaluation System ◽  
Care Setting ◽  
Primary Care Setting ◽  
Obstructive Sleep ◽  
Risk Evaluation System

We ascertained the prevalence of resistant hypertension (RH) among blacks and determined whether RH patients are at greater risk for obstructive sleep apnea (OSA) than hypertensives.Method. Data emanated from Metabolic Syndrome Outcome Study (MetSO), a study investigating metabolic syndrome among blacks in the primary-care setting. Sample of 200 patients (mean age = 63 ± 13 years; female = 61%) with a diagnosis of hypertension provided subjective and clinical data. RH was defined using the JNC 7and European Society guidelines. We assessed OSA risk using the Apnea Risk Evaluation System ARES), defining high risk as a total ARES score ≥6.Results. Overall, 26% met criteria for RH and 40% were at high OSA risk. Logistic regression analysis, adjusting for effects of age, gender, and medical co morbidities, showed that patients with RH were nearly 2.5 times more likely to be at high OSA risk, relative to those with hypertension (OR = 2.46, 95% CI: 1.03–5.88,P<.05).Conclusion. Our findings show that the prevalence of RH among blacks fell within the range of RH for the general hypertensive population (3–29%). However, patients with RH were at significantly greater risk of OSA compared to patients with hypertension.

Lessons Learned: Patient Strategies for a Type 2 Diabetes Intervention in a Primary Care Setting

2003 ◽  
Vol 29 (4) ◽  
pp. 673-681 ◽  
Author(s):  
Hllarea Amthauer ◽  
Bridget Gagilo ◽  
Russell E. Glasgow ◽  
Wendy Dortch ◽  
Diane K. King
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Lessons Learned ◽  
Diabetes Intervention

The Role of Rapport: Lessons Learned From Conducting Research in a Primary Care Setting

2006 ◽  
Vol 16 (5) ◽  
pp. 723-734 ◽  
Author(s):  
Bridget Gaglio ◽  
Candace C. Nelson ◽  
Diane King
Keyword(s):  
Primary Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Lessons Learned ◽  
Conducting Research

scholarly journals Treatment of depression in a low-income primary care setting with colocated mental health care.

2009 ◽  
Vol 27 (2) ◽  
pp. 161-171 ◽  
Author(s):  
Lisa A. Uebelacker ◽  
Marcia Smith ◽  
Angelique W. Lewis ◽  
Ryan Sasaki ◽  
Ivan W. Miller
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Low Income ◽  
Care Setting ◽  
Primary Care Setting ◽  
Treatment Of Depression

scholarly journals Development and Evaluation of a Mobile Decision Support System for Hypertension Management in the Primary Care Setting in Brazil: Mixed-Methods Field Study on Usability, Feasibility, and Utility (Preprint)

2018 ◽  
Author(s):  
Daniel Vitório Silveira ◽  
Milena Soriano Marcolino ◽  
Elaine Leandro Machado ◽  
Camila Gonçalves Ferreira ◽  
Maria Beatriz Moreira Alkmim ◽  
...  
Keyword(s):  
Primary Care ◽  
Decision Support ◽  
Cardiovascular Risk ◽  
Care Setting ◽  
Primary Care Setting ◽  
Middle Income Country ◽  
Income Country ◽  
Daily Routine ◽  
Evidence Based ◽  
Middle Income

BACKGROUND Despite being an important cardiovascular risk factor, hypertension has low control levels worldwide. Computerized clinical decision support systems (CDSSs) might be effective in reducing blood pressure with a potential impact in reducing cardiovascular risk. OBJECTIVE The goal of the research was to evaluate the feasibility, usability, and utility of a CDSS, TeleHAS (tele–hipertensão arterial sistêmica, or arterial hypertension system), in the care of patients with hypertension in the context of a primary care setting in a middle-income country. METHODS The TeleHAS app consists of a platform integrating clinical and laboratory data on a particular patient, from which it performs cardiovascular risk calculation and provides evidence-based recommendations derived from Brazilian and international guidelines for the management of hypertension and cardiovascular risk. Ten family physicians from different primary care units in the city of Montes Claros, Brazil, were randomly selected to use the CDSS for the care of hypertensive patients for 6 months. After 3 and 6 months, the feasibility, usability, and utility of the CDSS in the routine care of the health team was evaluated through a standardized questionnaire and semistructured interviews. RESULTS Throughout the study, clinicians registered 535 patients with hypertension, at an average of 1.24 consultations per patient. Women accounted for 80% (8/10) of participant doctors, median age was 31.5 years (interquartile range 27 to 59 years). As for feasibility, 100% of medical users claimed it was possible to use the app in the primary care setting, and for 80% (8/10) of them it was easy to incorporate its use into the daily routine and home visits. Nevertheless, 70% (7/10) of physicians claimed that the time taken to fill out the CDSS causes significant delays in service. Clinicians evaluated TeleHAS as good (8/10, 80% of users), with easy completion and friendly interface (10/10, 100%) and the potential to improve patients’ treatment (10/10, 100%). A total of 90% (9/10) of physicians had access to new knowledge about cardiovascular risk and hypertension through the app recommendations and found it useful to promote prevention and optimize treatment. CONCLUSIONS In this study, a CDSS developed to assist the management of patients with hypertension was feasible in the context of a primary health care setting in a middle-income country, with good user satisfaction and the potential to improve adherence to evidence-based practices.

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