Effectiveness of an Interventional Program for the Management of Hypertension through Strengthening of the Health Care Delivery System : A Pilot Study

摘要

Background: The aim of the study was to assess the effectiveness of an interventional program to improve hypertension management through strengthening of the health care delivery system. Methods: A pilot study was conducted from February to December 2014 in two off-site Family Medicine clinics of the Aga Khan Hospital Karachi, Pakistan. Patients aged u3e 40 years, with known hypertension were included. At the intervention site, Family Physicians were trained; individual and group education sessions were conducted for catchment population, while usual care was provided at the control site. Referral system between primary, secondary and tertiary levels of care was strengthened. Data was entered and analyzed in SPSS version 19. T-test for independent sample was used for comparison between intervention and control groups. Results: 118 patients were recruited but 90 patients (44 intervention, 46 control group) were included in the final analysis. Mean age of patients in intervention group was 50.5+ 8.7 years in comparison to 52.0 +8.3 years in the control group. A statistically significant mean difference was observed in systolic BP control in the intervention group (140.2 + 14.6 mm Hg) after a follow-up of six months. There was a significant difference in the mean scores of satisfaction levels between intervention (3.9 + 0.2) and control groups (3.7 + 0.2, P=0.003). Post intervention, 55% of patients in the intervention group and 39% in the control group were taking antihypertensive medications regularly. Conclusion: Intervention at primary care level along with strengthening of the health care delivery system should be undertaken to better manage hypertension