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A Mixed-Methods Approach for Evaluating Implementation Processes and Program Costs for a Hypertension Management
Aisha Tucker-Brown1, Michelle Spafford2, John Wittenborn3
1Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, 4770 Buford Highway NE, GA, 30341, Atlanta, USA. htj1@cdc.gov.
Summary
The Hypertension Management Program (HMP) was successfully adapted for a resource-limited setting, improving hypertension control. This team-based approach demonstrated cost-effectiveness and feasibility in a federally qualified health center.
Area of Science:
- Public Health
- Health Services Research
- Clinical Pharmacy
Background:
- Team-based care is effective for hypertension control.
- The Hypertension Management Program (HMP) was developed in high-resource settings.
- Federally Qualified Health Centers (FQHCs) often serve populations disproportionately affected by hypertension.
Purpose of the Study:
- To adapt and evaluate the HMP in a resource-limited FQHC.
- To describe the adaptation process and calculate program costs.
- To identify facilitators and barriers to HMP implementation.
Main Methods:
- A mixed-methods evaluation was used.
- Key components of the HMP were implemented with adaptations.
- Clinical pharmacists conducted hypertension management visits (HMVs).
Main Results:
- The HMP was adapted and implemented in an FQHC.
- Total program costs were $325,532 ($3.62 per patient per month).
- Facilitators included clinical pharmacist and provider engagement; barriers included staff turnover and provider time perception.
Conclusions:
- A team-based, patient-centered hypertension management approach can be adapted for FQHCs.
- The adapted HMP demonstrated feasibility and cost-effectiveness.
- Successful implementation requires addressing identified barriers.
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