Improving Hypertension Outcome Measurement in Low- and Middle-Income Countries

Area of Science:

• Cardiovascular medicine
• Health outcomes research
• Global health

Background:

• High blood pressure is a leading cause of preventable death globally.
• Effective hypertension control is challenging, particularly in low-resource settings.
• Patient-centered care is crucial but lacks standardized outcome measures.

Purpose of the Study:

• To define a standard set of patient-centered outcomes for evaluating hypertension management.
• To address the specific needs of low- and middle-income countries.
• To facilitate international benchmarking and value-based care.

Main Methods:

• Modified Delphi process involving 18 experts and patients from 15 countries.
• Informed by literature reviews, patient interviews, and expert surveys.
• Developed a consensus set of 18 clinical and patient-reported outcomes and case-mix variables.

Main Results:

• A core list of 18 patient-centered outcomes for hypertension care evaluation was established.
• Outcomes cover hypertension control, complications, quality of life, financial burden, medication burden, satisfaction, health literacy, and behaviors.
• Case-mix variables were identified for provider comparisons.

Conclusions:

• The developed outcome set reflects patient priorities and evidence-based practices.
• It addresses unique challenges in low- and middle-income countries while remaining globally relevant.
• This is a vital step towards international benchmarking and value-based hypertension management.