Abstract
The majority of patients with hypertension in Jordan have uncontrolled blood pressure. This study aimed to adapt and implement the hypertension management protocol (a module in the HEARTS technical package) in health care centers in Jordan and evaluate its effectiveness on hypertension management and control. The hypertension management protocol was adapted and implemented in six health centers followed by training of the healthcare staff on the adapted protocol. Patients above 18 years old who attended health centers during the study period were recruited consecutively. The blood pressure of 852 patients was monitored over 4 months, using an individual patient treatment card. At the baseline visit, the proportion of patients with uncontrolled blood pressure was 71.5%. After 4 months of the implementation of the protocol, the proportion of patients with uncontrolled blood pressure decreased to 29.1%. Of all studied characteristics, age was the only significant predictor of achieving blood pressure control. Patients aged ≤50 had a higher rate of controlled blood pressure readings after 4 months of implementation of the protocol compared to patients older than 60 years (OR = 1.98, 95% CI: 1.07, 3.67; P value = 0.028). In conclusion, the implementation of the HEARTS hypertension management protocol has successfully achieved better control of the blood pressure of the enrolled patients after 4 months of implementation. To achieve better control of hypertension in the general population, integrating evidence-based strategies for hypertension control that are listed in the HEART technical package into routine care is strongly recommended.
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Data availability
The data that support the findings of this study are available on request from the corresponding author.
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Funding
This analysis was conducted on behalf of Resolve to Save Lives. Resolve to Save Lives is funded by Bloomberg Philanthropies, the Bill and Melinda Gates Foundation, and Gates Philanthropy Partners, which is funded with support from the Chan Zuckerberg Foundation.
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MA, YK, OA, LK contributed to the study design and conceptualization. YK, OA developed the questionnaire. YK did the statistical analysis and interpretation of the results. MA, YK coordinated the questionnaire adaptation and data collection. MA, YK, OA, LK developed, revised, and approved the paper. MA, YK, OA, LK have read and approved the final paper.
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Nsour, M.A., Khader, Y., Al-Hadeethi, O.A. et al. Adaptation, implementation, and evaluation of the HEARTS technical package in primary health care settings in Jordan to improve the management of hypertension: a pilot study. J Hum Hypertens 37, 950–956 (2023). https://doi.org/10.1038/s41371-022-00792-9
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DOI: https://doi.org/10.1038/s41371-022-00792-9