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 - 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
SN - 0194-911X
VL - 73
SP - 990
EP - 997
JO - Hypertension
JF - Hypertension
IS - 5
ER -