Improving Hypertension Outcome Measurement in Low- and Middle-Income Countries
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-cent...
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American Heart Association
2019
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my.um.eprints.229422019-11-04T04:34:37Z http://eprints.um.edu.my/22942/ Improving Hypertension Outcome Measurement in Low- and Middle-Income Countries Zack, Rachel Okunade, Oluwakemi Olson, Elizabeth Salt, Matthew Amodeo, Celso Anchala, Raghupathy Berwanger, Otavio Campbell, Norm Chia, Yook Chin Damasceno, Albertino Phuong Do, Thi Nam Tamdja Dzudie, Anastase Fiuza, Manuela Mirza, Fareed Nitsch, Dorothea Ogedegbe, Gbenga Podpalov, Vladislav Schiffrin, Ernesto L. Vaz Carneiro, António Lamptey, Peter R Medicine 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. American Heart Association 2019 Article PeerReviewed 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 https://doi.org/10.1161/HYPERTENSIONAHA.118.11916 doi:10.1161/HYPERTENSIONAHA.118.11916 |
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R Medicine Zack, Rachel Okunade, Oluwakemi Olson, Elizabeth Salt, Matthew Amodeo, Celso Anchala, Raghupathy Berwanger, Otavio Campbell, Norm Chia, Yook Chin Damasceno, Albertino Phuong Do, Thi Nam Tamdja Dzudie, Anastase Fiuza, Manuela Mirza, Fareed Nitsch, Dorothea Ogedegbe, Gbenga Podpalov, Vladislav Schiffrin, Ernesto L. Vaz Carneiro, António Lamptey, Peter Improving Hypertension Outcome Measurement in Low- and Middle-Income Countries |
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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. |
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Article |
author |
Zack, Rachel Okunade, Oluwakemi Olson, Elizabeth Salt, Matthew Amodeo, Celso Anchala, Raghupathy Berwanger, Otavio Campbell, Norm Chia, Yook Chin Damasceno, Albertino Phuong Do, Thi Nam Tamdja Dzudie, Anastase Fiuza, Manuela Mirza, Fareed Nitsch, Dorothea Ogedegbe, Gbenga Podpalov, Vladislav Schiffrin, Ernesto L. Vaz Carneiro, António Lamptey, Peter |
author_facet |
Zack, Rachel Okunade, Oluwakemi Olson, Elizabeth Salt, Matthew Amodeo, Celso Anchala, Raghupathy Berwanger, Otavio Campbell, Norm Chia, Yook Chin Damasceno, Albertino Phuong Do, Thi Nam Tamdja Dzudie, Anastase Fiuza, Manuela Mirza, Fareed Nitsch, Dorothea Ogedegbe, Gbenga Podpalov, Vladislav Schiffrin, Ernesto L. Vaz Carneiro, António Lamptey, Peter |
author_sort |
Zack, Rachel |
title |
Improving Hypertension Outcome Measurement in Low- and Middle-Income Countries |
title_short |
Improving Hypertension Outcome Measurement in Low- and Middle-Income Countries |
title_full |
Improving Hypertension Outcome Measurement in Low- and Middle-Income Countries |
title_fullStr |
Improving Hypertension Outcome Measurement in Low- and Middle-Income Countries |
title_full_unstemmed |
Improving Hypertension Outcome Measurement in Low- and Middle-Income Countries |
title_sort |
improving hypertension outcome measurement in low- and middle-income countries |
publisher |
American Heart Association |
publishDate |
2019 |
url |
http://eprints.um.edu.my/22942/ https://doi.org/10.1161/HYPERTENSIONAHA.118.11916 |
_version_ |
1651867379529940992 |
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13.160551 |