TY - JOUR
T1 - Improving hypertension outcome measurement in low- and middle-income countries
AU - Zack, Rachel
AU - Okunade, Oluwakemi
AU - Olson, Elizabeth
AU - Salt, Matthew
AU - Amodeo, Celso
AU - Anchala, Raghupathy
AU - Berwanger, Otavio
AU - Campbell, Norm
AU - Chia, Yook Chin
AU - Damasceno, Albertino
AU - Phuong Do, Thi Nam
AU - Tamdja Dzudie, Anastase
AU - Fiuza, Manuela
AU - Mirza, Fareed
AU - Nitsch, Dorothea
AU - Ogedegbe, Gbenga
AU - Podpalov, Vladislav
AU - Schiffrin, Ernesto L.
AU - Vaz Carneiro, António
AU - Lamptey, Peter
N1 - Funding Information:
Funding was provided by the Novartis Foundation. Fareed Mirza, head of Healthcare and Outcomes Research at Novartis Foundation, was a nonvoting member of the WG.
Funding Information:
A. Damasceno received personal fee for conference from Astra Zeneca, Merck. C. Amodeo received personal fees (scientific board) from Servier laboratory, Merck; personal fees (paper) from Novartis; and personal fees (speaker) from ACHE laboratory. D. Nitsch received funding to conduct kidney research in Africa from GSK. E. Schiffrin received honoraria (Ad Boards) from Novartis, Actelion; and Research Grant (Discovery grant unrelated to Servier products) from Servier. Thi Nam Phuong DO received speaker fees from Astra Zeneca, Boehringer Ingelheim, MSD, Novartis, Sanofi Aventis, Servier and investigator research from Astra Zeneca, MSD, Servier. Norm Campbell received Personal Fees (Consultant to hypertension control programs in low resources setting) 2016–2017 from Novartis Foundation and Personal Fees (Consultant for accurate measurement of blood pressure (2017) from Midway Corporation. Vladislav Podpalov had patents: No 17881, issued by the Republic of Belarus: risk prediction tools for myocardial infarction or stroke in patients with arterial hypertension; No 17892, issued by the Republic of Belarus: risk prediction tools for risk of death depending on blood circulation disease in patients with arterial hypertension; No 17891, issued by the Republic of Belarus: risk prediction tool on predicting the risk of death in patients with hypertension. Yook-Chin Chia received speaker honorarium from Pfizer, sponsorship to conferences, research grant from Abbott, Novartis, MSD, Sanofi, Astra, Reckitt-Benckiser, Orient-Europharma, GSK, Boehringer Ingelheim, Servier, Merck, Merck-Serono, Bayer, Zeullig; speaker honorarium patents from UMMC and licencee Asia Diabetes Foundation, NGO study. The other authors report no conflicts.
Publisher Copyright:
© 2019 American Heart Association, Inc.
PY - 2019/5/1
Y1 - 2019/5/1
N2 - 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.
AB - 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.
KW - hypertension
KW - patient-centered care
KW - quality of life
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U2 - 10.1161/HYPERTENSIONAHA.118.11916
DO - 10.1161/HYPERTENSIONAHA.118.11916
M3 - Article
C2 - 30929516
AN - SCOPUS:85064725477
VL - 73
SP - 990
EP - 997
JO - Hypertension
JF - Hypertension
SN - 0194-911X
IS - 5
ER -