Improving Hypertension Outcome Measurement in Low- and Middle-Income Countries

Zack, Rachel and Okunade, Oluwakemi and Olson, Elizabeth and Salt, Matthew and Amodeo, Celso and Anchala, Raghupathy and Berwanger, Otavio and Campbell, Norm and Chia, Yook Chin and Damasceno, Albertino and Phuong Do, Thi Nam and Tamdja Dzudie, Anastase and Fiuza, Manuela and Mirza, Fareed and Nitsch, Dorothea and Ogedegbe, Gbenga and Podpalov, Vladislav and Schiffrin, Ernesto L. and Vaz Carneiro, António and Lamptey, Peter (2019) Improving Hypertension Outcome Measurement in Low- and Middle-Income Countries. Hypertension, 73 (5). pp. 990-997. ISSN 0194-911X

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High blood pressure is the leading modifiable risk factor for mortality, accounting for nearly 1 in 5 deaths worldwide and 1 in 11 in low-income countries. Hypertension control remains a challenge, especially in low-resource settings. One approach to improvement is the prioritization of patient-centered care. However, consensus on the outcomes that matter most to patients is lacking. We aimed to define a standard set of patient-centered outcomes for evaluating hypertension management in low- and middle-income countries. The International Consortium for Health Outcomes Measurement convened a Working Group of 18 experts and patients representing 15 countries. We used a modified Delphi process to reach consensus on a set of outcomes, case-mix variables, and a timeline to guide data collection. Literature reviews, patient interviews, a patient validation survey, and an open review by hypertension experts informed the set. The set contains 18 clinical and patient-reported outcomes that reflect patient priorities and evidence-based hypertension management and case-mix variables to allow comparisons between providers. The domains included are hypertension control, cardiovascular complications, health-related quality of life, financial burden of care, medication burden, satisfaction with care, health literacy, and health behaviors. We present a core list of outcomes for evaluating hypertension care. They account for the unique challenges healthcare providers and patients face in low- and middle-income countries, yet are relevant to all settings. We believe that it is a vital step toward international benchmarking in hypertension care and, ultimately, value-based hypertension management.

Item Type: Article
Uncontrolled Keywords: hypertension; patient-centered care; quality of life
Subjects: R Medicine
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 04 Nov 2019 04:34
Last Modified: 04 Nov 2019 04:34

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