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Standardization of Blood Pressure Management in Cedro Galán, a Semi-Rural Community in Nicaragua

Authors:
Holly O'Brien
Aly Strauss
E. Nicole Teal
Taylor Martin
Wendy Sanchez
Elimarys Perez-Colon

Keywords: Quality improvement; Patient outcomes; Equity in health care; Primary care; Cardiovascular diseases; Developing countries; Patient education; Guidelines

Abstract:
Research supports the use of evidence-based guidelines in the management of hypertension. However, there is limited literature regarding translation of these initiatives to resource-poor settings. Specifically, Nicaragua has no evidence of appropriate treatment or management of hypertension. A team from the University of South Florida Morsani College of Medicine created a community-specific, algorithm-based educational program to standardize management of hypertension in the semi-rural community of Cedro Galán. Patients enrolled had monthly monitoring of systolic and diastolic blood pressures. The launch of the pilot program was followed by evaluation and intervention six months later. Results were analyzed using retrospective chart review, and separated into pre-pilot, post-pilot, and post-intervention data. Primary and secondary outcomes included blood pressure, community adherence, and provider confidence. Mean systolic and diastolic pressures for all patients prior to the pilot (n=10) were 146/78 mmHg, between pilot and intervention (n=16) were 153/83 mmHg, and after intervention (n=17) were 145/81 mmHg. Patient adherence to medications and provider confidence increased, and patient clinic appointment attendance increased from a median of 47% at baseline to a median of 100% post-intervention. Our study suggests that community-specific, evidence-based education programs that include algorithm development can increase community adherence, provider confidence, and also blood pressure. Limitations include lack of similar research to be used for comparison, and we stress the need for continued study in this subject.

Pages: 33 to 39

Copyright: Copyright (c) IARIA, 2017

Publication date: November 12, 2017

Published in: conference

ISSN: 2308-4553

ISBN: 978-1-61208-604-0

Location: Barcelona, Spain

Dates: from November 12, 2017 to November 16, 2017